关键词: 肝癌, 静脉血栓栓塞症, COMPASS-CAT评分, Khorana评分, D-二聚体, 纤维蛋白降解产物

Abstract: Objective To evaluate the value of COMPASS-CAT, Khorana score, D-dimer (D-D), and fibrin degradation products (FDP) in predicting venous thrombosis in patients diagnosed with liver cancer.Methods A retrospective analysis was conducted on the clinical data of 125 patients with liver cancer from August 2021 to August 2023. These patients were divided into two groups: the VTE group (27 cases) and the non-VTE group (98 cases) based on the occurrence of venous thromboembolism (VTE) within 3 days after treatment. The clinical data of all patients were collected, including their COMPASS-CAT and Khorana scores, as well as the levels of serum D-D and FDP 3 day after radical resection of liver cancer. The predictive value of serum D-D, FDP alone and in combination with COMPASS-CAT score in predicting the occurrence of VTE in patients with liver cancer was analyzed using ROC curve. Multivariate analysis was conducted using unconditional logistic stepwise regression analysis.Results The VTE group had 5 cases (18.52%) with a history of VTE, 11 cases (40.74%) with hypertension, 9 cases (33.33%) with a central venous catheter, 19 cases (70.37%) with a COMPASS CAT score ≥7, serum D-D level of (21.04±7.81) mg/L, and serum FDP level of (62. 55±20.48) μg/mL. These numbers were all higher compared to the non-VTE group, which had 0 cases with a VTE history (0.00%), 7 cases with hypertension (14.00%), 4 cases with a central venous catheter (8.00%), 15 cases with a COMPASS-CAT score ≥7 (30.00%), serum D-D level of (6.65±2.19) mg/L, and serum FDP level of (17.96±5.82) μg/mL (P＜0.05). The area under the ROC curve of serum D-D and FDP, and their combination in predicting the occurrence of VTE in liver cancer patients was 0.911, 0.883, and 0.949, respectively. Multivariate logistic regression analysis showed that a history of VTE, hypertension, central venous catheter, COMPASS-CAT score, serum D-D and FDP were risk factors for VTE in patients with liver cancer (P<0.05).Conclusion COMPASS-CAT score, serum D-D and FDP show significant differences between VTE group and non-VTE group, and can be used to predict the occurrence of VTE in patients with liver cancer. However, the Khorana score does not show a significant difference between the two groups and has limited predictive value. In addition, combining the prediction of serum D-D, FDP and COMPASS-CAT score can further enhance the predictive value.

Key words: Liver cancer, Venous thromboembolism, COMPASS-CAT score, Khorana score, D-dimer, Fibrin degradation products