晚期肺腺癌合并肺栓塞临床特征分析及D-二聚体对其预测价值
Analysis of Clinical Characteristics of Advanced Lung Adenocarcinoma with Pulmonary Embolism and Predictive Value of D-Dimer

目的：探讨晚期肺腺癌合并肺栓塞患者的临床特征，分析D-二聚体对其预测价值。方法：选取2015.01~2020.01在我院诊断为晚期肺腺癌合并肺栓塞的59例患者为研究对象，收集同期59例肺晚期腺癌不合并肺栓塞患者作为对照组，记录入组患者临床资料，使用SPSS25.0软件进行分析。结果：晚期肺腺癌合并肺栓塞组的D-二聚体的水平明显高于对照组(P < 0.001)，Spearman相关分析提示D-二聚体水平与晚期肺腺癌合并肺栓塞的具有高度相关性(r= 0.602, P < 0.001)；受试者工作特征曲线(ROC)显示：D-二聚体预测肺癌合并肺栓塞的AUC值0.848 (95% CI: 0.779~0.919)，最佳临界值1365 ng/L，此时灵敏度为81.4%，特异度为79.7%。结论：D-二聚体是晚期肺腺癌合并肺栓塞的独立危险因素，D-二聚体的临界值大于1365 ng/L时，对晚期肺腺癌合并肺栓塞有重要的预测价值。
Objective: To investigate the clinical features of patients with advanced lung adenocarcinoma complicated with pulmonary embolism, and to analyze the predictive value of D-dimer. Methods: Fifty-nine patients diagnosed with advanced pulmonary adenocarcinoma complicated with pulmonary embolism in our hospital were selected as study group from 2015.01~2020.01, and 59 patients with advanced pulmonary adenocarcinoma without pulmonary embolism were collected as the control group. The clinical data information of the patient was recorded, the results were analyzed by SPSS25.0. Result: The levels of D-dimer were significantly increased in the study group compared with control group (P < 0.001). Spearman correlation showed that the levels of D-dimer was highly correlated with the lung adenocarcinoma combined with PE (r = 0.602, P < 0.001); The area under the Receiver Operating Characteristic Curve (ROC) showed that value of D-dimer predicted advanced lung adenocarcinoma combined with PE was 0.848 (95% CI: 0.779~0.919), and cut-off value was 1365 ng/L. At this time, the sensitivity and specificity were 81.4% and 79.7% respectively. Conclusion: D-dimer is an independent risk factor for advanced lung adenocarcinoma with pulmonary embolism. When the cut-off value of D-dimer is greater than 1365 ng/L, it has important predictive value for the disease.