生殖细胞瘤（GCT）是一种高度可治愈的恶性肿瘤。静脉血栓栓塞（VTE）是一种严重的并发症，需要更好的风险评估模型（RAM）。首次化疗的转移性GCT患者中VTE发生率和相关危险因素的识别。开发一种RAM，并将其与Khorana风险评分（KRS）和Padua预测评分（PPS）进行比较。我们回顾性分析了IS-IIIC分期的GCT患者。使用逻辑回归法确定VTE的危险因素。计算了开发的RAM，KRS和PPS的受试者工作特征曲线下面积（AUC-ROC），Akaike信息标准（AIC）和贝叶斯信息标准（BIC）。495名符合条件的患者中，69名（13.9％）发生了VTE，其中40名发生在化疗前。我们的RAM中显著的危险因素包括静脉压迫（OR：8.96；95％CI：2.85-28.13；p < 0.001），临床分期IIIB-IIIC（OR：5.68；95％CI：1.82-17.70；p = 0.003）和血红蛋白浓度（每1g/dL下降的OR：1.32；95％CI：1.03-1.67；p = 0.026）。KRS≥3（OR：3.31；95％CI：1.77-6.20；p < 0.001），PPS 4-5（OR：3.06；95％CI：1.49-6.29；p = 0.002）和PPS > 5（OR：8.05；95％CI：3.79-17.13；p < 0.001）与VTE风险相关。开发的RAM，KRS和PPS的诊断标准（AUC-ROC，AIC，BIC）分别为（0.885；0.567；-1641），（0.588；0.839；-1576）和（0.700；0.799；-1585）。在分数数值上，高风险的最佳分界点为≥9，敏感性、特异性、阳性预测值和阴性预测值分别为0.78、0.77、0.35和0.96。我们基于静脉压迫、临床分期和血红蛋白浓度的RAM相对于KRS和PPS显示出更好的效果。GCT患者中VTE频繁发生。© 2023 The Authors. 由John Wiley & Sons Ltd.出版的Cancer Medicine发布

Germ cell tumours (GCT) are highly curable malignancies. Venous thromboembolism (VTE) is a serious complication, needing better risk assessment models (RAM).Identification of VTE incidence and risk factors in metastatic GCT patients starting first-line chemotherapy. Developing a RAM and comparing it to Khorana risk score (KRS) and Padua Prediction Score (PPS).We retrospectively analysed GCT patients staged IS-IIIC. VTE risk factors were identified with logistic regression. Area under curve of receiver operating characteristic (AUC-ROC), Akaike and Bayesian Information Criteria (AIC, BIC) were calculated for the developed RAM, KRS and PPS.Among 495 eligible patients, VTE occurred in 69 (13.9%), including 40 prior to chemotherapy. Vein compression (OR: 8.96; 95% CI: 2.85-28.13; p < 0.001), clinical stage IIIB-IIIC (OR: 5.68; 95% CI: 1.82-17.70; p = 0.003) and haemoglobin concentration (OR for 1 g/dL decrease: 1.32; 95% CI: 1.03-1.67; p = 0.026) were significant in our RAM. KRS ≥ 3 (OR: 3.31; 95% CI: 1.77-6.20; p < 0.001), PPS 4-5 (OR: 3.06; 95% CI: 1.49-6.29; p = 0.002) and PPS > 5 (OR 8.05; 95% CI 3.79-17.13; p < 0.001) correlated with VTE risk. Diagnostic criteria (AUC-ROC, AIC, BIC) for the developed RAM, KRS and PPS were (0.885; 0.567; -1641), (0.588; 0.839; -1576) and (0.700; 0.799; -1585), respectively. In the numerical score, the optimal cut-off point for high-risk was ≥9, with sensitivity, specificity, positive and negative predictive value of 0.78, 0.77, 0.35 and 0.96, respectively.Our RAM, based on vein compression, clinical stage and haemoglobin concentration proved superior to both KRS and PPS. VTE is frequent in GCT patients.© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.