Key result
Concurrent DIC is linked to a ~7-fold higher rate of NBTE in lung cancer.
Why the study?
Nonbacterial thrombotic endocarditis (NBTE) occurs in patients with lung cancer, but its features and clinical significance were not well characterized.
Observational (n=142)
No
Nonbacterial thrombotic endocarditis is a notable complication in lung cancer patients, particularly those with adenocarcinoma, and is strongly associated with DIC and fatal systemic thromboembolic events.
NBTE merits consideration in lung cancer patients with thromboembolism; leaves open prospective studies on detection and management.
肺癌患者における非細菌性血栓性心内膜炎 (nonbacterial thrombotic endocarditis: NBTE) の特徴と意義を調べるため, 肺癌剖検142例の臨床病理学的検討を行った. 11例 (7.7%) にNBTEを認め, 組織型別には腺癌62例中8例 (13%), 扁平上皮癌35例中3例 (8.6%) の順で, 小細胞癌 (34例) にはNBTEの合併はみられなかった. 一方142例中11例に病理学的に播種性血管内血液凝固 (disseminated intravascular coagulation: DIC) がみられた. このうち4例 (36%) はNBTE症例で, DICとNBTEとの間には有意の相関を認めた (P<0.01). NBTE11例中7例に全身の血栓塞栓症を認め, その部位は脾 (7例), 脳 (5例), 腎 (4例), 心 (3例), 腸間膜 (2例) であった. 多発性出血性脳梗塞 (4例) はいずれも致命的で, 心筋梗塞や腸間膜動脈塞栓症による腹膜炎も死因となっていた. NBTEは肺癌に稀ならず合併し, それによる血栓塞栓症は予後を左右する事もあるため, 臨床医はNBTEの特徴と意義を熟知する必要がある.
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Tamura et al. (1994) conducted an observational in Lung cancer (n=142). Disseminated intravascular coagulation (DIC) vs. Without DIC was evaluated on Incidence of nonbacterial thrombotic endocarditis (NBTE) (p=<0.01). Nonbacterial thrombotic endocarditis was present in 7.7% of autopsied lung cancer patients and was significantly more frequent in those with concurrent disseminated intravascular coagulation (36.4% vs 5.3%, p<0.01).
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