背景:癌症是全球死亡的主要原因之一,和心肺合并症可能进一步对癌症预后产生不利影响。我们最近将肺癌相关的肺动脉高压(PH)描述为PH和肺癌合并症的新形式。虽然与无PH的患者相比,合并PH的肺癌患者的总生存率显著降低,PH在其他癌症中的患病率和影响尚不清楚.
方法:在本回顾性研究中,观察性队列研究,我们分析了1184例非肺癌实体瘤患者中PH的患病率和对临床结局的影响,也就是说,结直肠,头部和颈部,泌尿外科,乳房或中枢神经系统肿瘤,使用CT确定的PH的替代标记。
结果:该队列中的PH患病率为10.98%。Cox比例风险模型显示患有PH的癌症患者的中位生存时间显着减少(837对2074天;p<0.001)。然而,肺转移与PH无相关性。亚组分析表明,PH与肺和心脏功能降低有关。此外,PH与全身动脉高血压(p<0.001)和冠状动脉疾病(p=0.014)有关,但不是肺气肿.
结论:在这项研究中,在肺癌患者中,与先前发表的结果相比,具有PH替代参数的癌症患者较少.因此,与肺癌相比,其他癌症中PH的患病率可能较低;然而,PH对预后仍有负面影响。此外,我们的数据没有提供肺转移导致PH的证据.因此,我们的结果支持以下观点:肺癌相关PH代表了一种新的PH类别.我们的结果也强调了在心脏肿瘤学领域进一步研究的重要性。
BACKGROUND: Cancer is one of the leading causes of death worldwide, and cardiopulmonary comorbidities may further adversely affect cancer prognosis. We recently described lung cancer-associated pulmonary hypertension (PH) as a new form of PH and comorbidity of lung cancer. While patients with lung cancer with PH had significantly reduced overall survival compared with patients without PH, the prevalence and impact of PH in other cancers remain unclear.
METHODS: In this retrospective, observational cohort study, we analysed the prevalence and impact of PH on clinical outcomes in 1184 patients with solid tumours other than lung cancer, that is, colorectal, head and neck, urological, breast or central nervous system tumours, using surrogate markers for PH determined by CT.
RESULTS: PH prevalence in this cohort was 10.98%. A Cox proportional hazard model revealed a significant reduction in the median survival time of patients with cancer with PH (837 vs 2074 days; p<0.001). However, there was no correlation between pulmonary metastases and PH. A subgroup analysis showed that PH was linked to decreased lung and cardiac function. Additionally, PH was associated with systemic arterial hypertension (p<0.001) and coronary artery disease (p=0.014), but not emphysema.
CONCLUSIONS: In this study, fewer patients with cancer had surrogate parameters for PH compared with previously published results among patients with lung cancer. Consequently, the prevalence of PH in other cancers might be lower compared with lung cancer; however, PH still has a negative impact on prognosis. Furthermore, our data does not provide evidence that lung metastases cause PH. Thus, our results support the idea that lung cancer-associated PH represents a new category of PH. Our results also highlight the importance of further studies in the field of cardio-oncology.