Clinical features of pulmonary embolism in patients with lung cancer: A meta-analysis

• Published in: PloS one 2019-09, Vol.14 (9), p.e0223230-e0223230
• Main Authors: Hua, Xin, Han, Shu-Hua, Wei, Shu-Zhen, Wu, Ying, Sha, Jun, Zhu, Xiao-Li
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma of Lung - complications; Adenocarcinoma of Lung - diagnosis; Adenocarcinoma of Lung - pathology; Antigens; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Blood; Cancer patients; Cancer therapies; Carcinoembryonic antigen; Carcinoembryonic Antigen - blood; Carcinoma, Bronchogenic - complications; Carcinoma, Bronchogenic - diagnosis; Carcinoma, Bronchogenic - pathology; Care and treatment; Central Venous Catheters - adverse effects; Chemotherapy; Chronic obstructive pulmonary disease; Complications and side effects; Confidence intervals; Continuity (mathematics); Dimers; Embolism; Embolisms; Fibrin Fibrinogen Degradation Products - metabolism; Health aspects; Hospitals; Humans; Infrastructure (Economics); Low level; Lung cancer; Lung diseases; Lung Neoplasms - complications; Lung Neoplasms - diagnosis; Lung Neoplasms - pathology; Medical ethics; Medical instruments; Medical personnel; Medical prognosis; Medical schools; Medicine and Health Sciences; Meta-analysis; Mortality; Neoplasm Staging; NMR; Nuclear magnetic resonance; Obstructive lung disease; Odds Ratio; Oxygen; Oxygen - metabolism; Partial Pressure; Patients; Physical Sciences; Physicians; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - pathology; Pulmonary embolism; Pulmonary Embolism - diagnosis; Pulmonary Embolism - etiology; Pulmonary Embolism - pathology; Pulmonary embolisms; Pulmonary hypertension; Reliability analysis; Research and Analysis Methods; Respiratory tract diseases; Risk Factors; Science Policy; Sensitivity analysis; Studies; Thromboembolism; Thrombosis; Tumors
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0223230

Pulmonary 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. Multiple 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. In 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. These 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.