Abstract
BackgroundPulmonary embolism (PE) is correlated with increased mortality among patients with lung cancer (LC). The characteristics of patients with LC presenting with PE have not been fully established, and our meta-analysis aims to comprehensively investigate the clinical characteristics associated with PE in patients with LC to help physicians identify PE earlier in these patients.MethodsMultiple databases were searched, including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure and Wanfang. Odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were used as effect measures for dichotomous and continuous variables, respectively. Moreover, Egger’s test, Begg’s test and a sensitivity analysis were performed to assess the publication bias and reliability of the articles.ResultsIn total, 16 studies were included in our meta-analysis. The results indicated that history of chronic obstructive pulmonary disease (OR = 2.59, 95% CI: 1.09, 6.15; P = 0.03), adenocarcinoma (OR = 2.28, 95% CI: 1.88, 2.77; P < 0.01), advanced tumour stage (TNM III-IV vs. I-II, OR = 2.38, 95% CI: 1.99, 2.86; P < 0.01), history of central venous catheter (OR = 1.95, 95% CI: 1.36, 2.78; P < 0.01), history of chemotherapy (OR = 2.32, 95% CI: 1.80, 2.99, P < 0.01), high levels of D-dimer (WMD = 4.31, 95% CI: 2.53, 6.10; P < 0.01) and carcinoembryonic antigen (WMD = 10.30, 95% CI: 9.95, 10.64; P < 0.01) and a low level of partial pressure of oxygen (WMD = -25.97, 95% CI: -31.31, -20.62; P < 0.01) were clinical features of LC patients with PE compared to those without PE.ConclusionsThese results reveal that LC patients with PE have specific clinical features, including but not limited to several cancer- and treatment-related factors, that may help their early identification.
Highlights
In 1868, Trousseau first identified a close connection between venous thromboembolism (VTE) and cancer [1]
These results reveal that lung cancer (LC) patients with Pulmonary embolism (PE) have specific clinical features, including but not limited to several cancer- and treatment-related factors, that may help their early identification
VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE); the former often leads to post-thrombotic syndrome and the latter often results in more dangerous complications, such as pulmonary infarction and chronic thromboembolic pulmonary hypertension [5]
Summary
In 1868, Trousseau first identified a close connection between venous thromboembolism (VTE) and cancer [1]. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE); the former often leads to post-thrombotic syndrome and the latter often results in more dangerous complications, such as pulmonary infarction and chronic thromboembolic pulmonary hypertension [5]. According to a previous study, lung cancer (LC) is the malignancy most commonly associated with PE [6]. Multiple clinical studies have confirmed that the occurrence of PE is associated with an increased death rate among LC patients [7,8,9,10], accounting for 10% of deaths [11]. Pulmonary embolism (PE) is correlated with increased mortality among patients with lung cancer (LC).
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