Many cancer patients will experience venous thromboembolism (VTE) at some stage, with the highest rate in the initial period following diagnosis. Novel cancer therapies may further enhance the risk. VTE in a cancer setting is associated with poor prognostic, a decreased quality of life, and high healthcare costs. If thromboprophylaxis in hospitalized cancer patients and perioperative settings is widely accepted in clinical practice and supported by the guidelines, it is not the same situation in ambulatory cancer patient settings. The guidelines do not recommend primary thromboprophylaxis, except in high-risk cases. However, nowadays, risk stratification is still challenging, although many tools have been developed. The Khrorana score remains the most used method, but it has many limits. This narrative review aims to present the current relevant knowledge of VTE risk assessment in ambulatory cancer patients, starting from the guideline recommendations and continuing with the specific risk assessment methods and machine learning models approaches. Biomarkers, genetic, and clinical features were tested alone or in groups. Old and new models used in VTE risk assessment are exposed, underlining their clinical utility. Imaging and biomolecular approaches to VTE screening of outpatients with cancer are also presented, which could help clinical decisions.
许多癌症患者在其病程的某个阶段会经历静脉血栓栓塞症（VTE），其中诊断初期发生率最高。新型癌症疗法可能进一步增加这一风险。癌症背景下的VTE与不良预后、生活质量下降以及高昂的医疗费用相关。尽管住院癌症患者及围手术期患者的血栓预防在临床实践中已被广泛接受并获指南支持，但门诊癌症患者的情况则有所不同。除高风险病例外，指南并不推荐常规进行一级血栓预防。然而，尽管已开发出多种评估工具，目前的风险分层仍具挑战性。Khrorana评分是目前最常用的方法，但其存在诸多局限性。本文旨在通过叙述性综述，从指南建议出发，系统阐述门诊癌症患者VTE风险评估的相关知识，涵盖具体的风险评估方法及机器学习模型的应用。研究已对生物标志物、遗传特征及临床因素进行了单独或联合测试。文中介绍了用于VTE风险评估的传统及新型模型，并着重强调了它们的临床实用性。同时，还探讨了针对癌症门诊患者的VTE筛查影像学与生物分子学方法，这些方法可能为临床决策提供帮助。
肿瘤(癌症)患者之家