广州医药 ›› 2021, Vol. 52 ›› Issue (6): 54-58.DOI: 10.3969/j.issn.1000-8535.2021.06.011

• 论著 • 上一篇    下一篇

乳腺癌化疗患者完全输液港相关血栓形成的因素分析

熊白玉1, 朱玮2   

  1. 1 广州市第一人民医院乳腺外科(广州 510180);
    2 广东省中医院大学城医院心血管二科(广州 510006)
  • 收稿日期:2021-06-02 出版日期:2021-11-20 发布日期:2021-11-26
  • 通讯作者: 熊白玉,E-mail:895504883@qq.com

Analysis of factors of venous thrombosis among breast cancer patients with totally implantable access port for chemotherapy

XIONG Baiyu1, ZHU Wei2   

  1. 1 Department of Breast Surgery, Guangzhou First People's Hospital, Guangzhou 510180, China;
    2 Department of Cardio-Thoracic Surgery, Traditional Chinese Medicine Hospital of Guangdong Province, Guangzhou 510006, China
  • Received:2021-06-02 Online:2021-11-20 Published:2021-11-26

摘要: 目的 回顾性分析因化疗需要行完全植入式输液港的乳腺癌患者相关血栓形成的因素。方法 收集广州市第一人民医院乳腺外科2018年5月—2019年4月期间行植入式输液港置入术的60例乳腺癌患者相关资料,采用SPSS 26.0软件进行统计学分析。结果 输液港相关血栓形成(catheter related thrombosis,CRT)发生率为21/60(35%)。BMI≤24的患者CRT发生率为30.3%,BMI>24则为40.74%;行4、6、8次化疗的CRT发生率分别为20%、33.34%、44.12%,导管末端位于T5-T8的CRT发生分别为:66.67%, 26.09%, 28.57%, 50%;Ki-67高表达的血栓发生率为27.5%,低Ki-67表达则为50%;导管材质为聚氨酯的血栓发生率为47.62%,硅胶材质则为28.21%,但差异均无统计学意义(P>0.05)。雌激素受体/孕激素受体(estragen receptor/progesterone receptor,ER/PR)阴性的CRT发生率为60%,ER/PR阳性则为23.8%(P<0.05);人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)阳性CRT发生率为50%,HER-2阴性CRT发生率则为23.53%(P<0.05)。多因素分析:相对于ER/PR阳性,ER/PR阴性将增加CRT的发生(OR=4.482, 95%CI:1.116~17.998, P<0.05);Ki-67的表达对血栓形成的影响具有统计学意义(OR=7.051, 95%CI:1.513~32.858, P<0.05);HER-2表达对CRT的形成均无统计学意义(OR=0.254,95%CI:0.058~1.115, P>0.05)。结论 血栓形成是植入式输液港术后常见的并发症,与肿瘤ER/PR表达相关,临床上应得到重视。

关键词: 完全植入式输液港, 导管相关血栓形成, 雌激素受体, 人表皮生长因子受体-2

Abstract: Objective To analyse the factors that lead to venous thrombosis among breast cancer patients who need totally implantable access port(TIAP) for chemotherapy. Methods Collecting the clinical data of 60 breast patients admitted to Guanzhou First People's Hospital from May 2018 to April 2019, analysed with SPSS 26.0. Results Catheter-related thrombosis(CRT) occurred in 21 out of 60(35%) patients with TIAP. 30.3% patients with BMI≤24 and 40.74% patients with BMI>24 had CRT, and incidences of CRT were 20%, 33.34%, 44.12% at the fourth, sixth, eighth therapy respectively. The access terminal position at T5-T8 had 66.67%, 26.09%, 28.57%, 50% of incidence for CRT respectively. 27.5% CRT was with high Ki-67 expression and 50% CRT was with low Ki-67 expression; 47.62% patients with polyurethane catheter and 28.21% patients with silicone catheter got CRT. There were no significant differences in the comparisons above. CRT incidence in ER/PR negative patients was 60%,while 23.08% in ER/PR positive patients (P<0.05). In HER-2 positive and negative patients, the incidences of CRT were 50% and 23.53% (P<0.05). Logistic regression noticed that ER/PR negative would increase the incidence of CRT(OR=4.482, 95%CI:1.116~17.998, P<0.05), low Ki-67 expression would accelerate CRT(OR=7.051, 95%CI:1.513~32.858, P<0.05). There was no significant difference in the formation of CRT with HER-2 expression(OR=0.254, 95%CI:0.058~1.115, P>0.05). Conclusion CRT was a common complication of TIAP, which related with ER/PR expression, and should pay attention to during clinical practices.

Key words: totally implantable access port, catheter-related thrombosis, estrogen recepter, human epidermal growth facter recepter-2