Objective To investigate the risk factors, clinical characteristics and prognostic factors of venous thrombosis (and pulmonary embolism) in patients with idiopathic hypereosinophilia (IHE) so as to provide a theoretical basis for clinical prevention of venous thrombosis and improve prognosis.Methods Thirty-nine patients with IHE admitted to West China Hospital of Sichuan University from January 2010 to January 2022 were collected in this retrospective case-control study to explore the risk factors of venous thrombosis (including pulmonary embolism) and thrombosis recurrence after treatment. Results There were 17 (43.5%) patients combined with venous thrombosis of 39 patients with IHE. In the patients with vascular involvement, pulmonary embolism was the initial expression of IHE accounted for 29% (5/17). patients of IHE with pulmonary embolism were younger [44 (24.5 - 51.0) vs. 56 (46.3 - 67.8) year, P=0.035] and had higher peak absolute eosinophil counts [11.7 (7.2 - 26.5)×109/L vs. 3.8 (2.9 - 6.7)×109/L, P=0.020] than those without pulmonary embolism. After a mean follow-up of 13 months (2 - 21 months), thrombosis recurred in 35.3% (6/17) of patients. Persistent increasing in eosinophils (>0.5×109/L) was an independent risk factor for thrombus recurrence (odds ratio 13.33, 95% confidential interval 1.069 - 166.374). Conclusions Thrombosis is a common vascular impaired complication in IHE , and increased eosinophilia is a risk factor for thrombosis and thrombus recurrence after therapy. Controlling and monitoring the eosinophilic cell levels in patients with IHE may avoid severe comorbidities.
ObjectiveTo systematically investigate the clinical characteristics, risk factors, and prognostic determinants of lung cancer (LC) in patients with combined pulmonary fibrosis and emphysema (CPFE). MethodsA total of 180 CPFE patients admitted to West China Hospital of Sichuan University between December 2010 and December 2022 were collected in this retrospective study to explore the risk factors and prognosis of patients complicated with lung cancer. ResultsCPFE-LC predominantly occurs in elderly male smokers, with squamous cell carcinoma (33.33%) and adenocarcinoma (35.29%) being the most prevalent histological subtypes. Compared with CPFE patients, those with CPFE-LC demonstrated significantly higher proportions of males, current or former smokers, smoking index values, lymphocyte counts, neutrophil-to-lymphocyte ratios, serum albumin levels, fibrinogen levels, FEV1%pred, and VC%pred. However, logistic regression analysis identified only male (OR=19.92, 95%CI 2.83-140.27) and elevated fibrinogen levels (OR=2.09, 95%CI 1.47-2.97) as independent risk factors for lung cancer development in CPFE patients. CPFE-LC patients exhibited significantly shorter survival than CPFE patients (1.67 years vs. 4.92 years, P<0.05). Kaplan-Meier survival analysis revealed no significant difference in survival among CPFE-LC patients with different histological subtypes (squamous cell carcinoma vs. adenocarcinoma vs. others, P>0.05). ConclusionsMale and fibrinogen levels are independent risk factors for lung cancer development in patients with CPFE. Patients with CPFE-LC exhibited significantly shortened survival and poor prognosis. This unfavorable prognosis is closely associated with nutritional status, advanced tumor stage, metastasis status, and treatment modalities, but shows no significant association with histopathological type.
