title: [Identification of patients at high risk of cancer after a venous thromboembolic disease].
abstract: OBJECTIVE
  Assessment of cancer screening in the context of venous thromboembolic disease (VTE) remains controversial. We tried to characterize a population at high risk of developing cancer among patients suffering from VTE.
  
  
  METHODS
  We conducted a retrospective ancillary case-control study among patients with VTE who later had a positive diagnosis of cancer. We assessed the association of cancer with characteristic features of VTE and with the results for four biological markers.
  
  
  RESULTS
  Our population included 142 patients (53% men, median age 71 years). Two years after VTE, 24 patients (17%) had cancer. Median values for D-dimers, fibrin monomers and SP-selectin were significantly higher among patients who developed cancer. Logistic regression enabled us to identify two parameters targeting patients with a high risk of cancer: bilateral venous thrombosis (OR: 4.41, 95%CI: 1.41-13.78, P=0.01) and D-dimers superior to 3.8 μg/mL (OR: 3.68, 95%CI: 1.36-9.94, P=0.01). The information provided by these two characteristics was additive; 58% of patients in our population who had both factors developed cancer.
  
  
  CONCLUSIONS
  Bilateral venous thrombosis and D-dimers superior to 3.8 μg/mL are highly associated with carcinoma. This result requires a prospective validation. It could be useful in limiting the screening process to the population most at risk.
authors.affiliation: Clinique Universitaire de Médecine Vasculaire, CHU de Grenoble, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Chevallier-Grenot
authors.forename: B
authors.initials: B
authors.lastname: Bulabois
authors.forename: C
authors.initials: C
authors.lastname: Seinturier
authors.forename: C
authors.initials: C
authors.lastname: Genty
authors.forename: J-L
authors.initials: JL
authors.lastname: Bosson
authors.forename: G
authors.initials: G
authors.lastname: Pernod
mesh_terms: D000368:Aged; D015415:Biomarkers; D016022:Case-Control Studies; D055252:Cell-Derived Microparticles; D055088:Early Detection of Cancer; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D019007:P-Selectin / Q000032:analysis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D019851:Thrombophilia / Q000209:etiology; D013997:Time Factors; D054556:Venous Thromboembolism / Q000209:etiology*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D019007:P-Selectin; C036309:fibrin fragment D; C011468:fibrinmonomer