Cerebrovascular complications in cancer patients
Cerebrovascular complications in cancer patients
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DOI：
10.1016/s0733-8619(02)00066-x
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发表时间：
2003-02-01
影响因子：
2.4
通讯作者：
Rogers, LR
中科院分区：
文献类型：
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作者：
Rogers, LR
脑血管疾病是癌症患者脑症状的常见原因。这些疾病的最大研究是纪念斯隆-凯特琳中心的尸检研究，其中3426例死于全身性癌症的患者中有500例（14.6%）被发现患有脑梗死或脑梗死[1]。表1显示了脑血管疾病的类型和有症状患者的百分比。这项研究证明，与非癌症患者相比，癌症患者中风的原因往往是独特的。典型的原因是与癌症相关的凝血障碍、脑转移、癌症治疗并发症和脑感染。中风的类型取决于癌症的类型和阶段以及癌症治疗的类型。表2和表3将病理状况与肿瘤类型和临床环境相关联。Gratis等人[1]的研究涵盖了1970年至1981年期间死亡的患者。由于放射治疗、化学治疗、免疫治疗和骨髓移植的使用等新疗法的发展，癌症患者脑血管疾病的类型和病因可能有所不同。在一项回顾性综述中，Coplin等人[2]在接受骨髓移植的1245例患者中发现了36例（2.9%）脑出血或梗死。在原发性脑肿瘤患者中，可能存在与肿瘤生长、新生血管或肿瘤治疗相关的血管疾病。本文综述了与系统性癌症和原发性中枢神经系统肿瘤相关的脑血管疾病，重点介绍了有助于诊断的临床表现和检查。识别这种疾病可以导致有效的治疗，在某些患者中，可以导致癌症的诊断。
Cerebrovascular disease is a frequent cause of cerebral symptoms in cancer patients. The largest study of these disorders is an autopsy study from Memorial Sloan-Kettering Center, in which 500 out of 3426 patients (14.6%) dying with systemic cancer were found to have cerebral infarctions or hemorrhages [1]. Table 1 shows the type of cerebrovascular disorder and the percentage of patients who were symptomatic. This study documents that the causes of stroke are often unique to the cancer patient, as compared with patients without cancer. The typical causes are coagulation disorders related to the cancer, cerebral metastasis, complications of cancer treatment, and cerebral infection. The type of stroke depends on the type and stage of cancer and the type of antineoplastic treatment. Tables 2 and 3 correlate the pathologic condition with the tumor type and clinical setting. The study by Gratis et al [1] encompassed patients dying between 1970 and 1981. It is likely that the type and etiology of cerebrovascular disease in cancer patients is different now, because of advances in antineoplastic therapies, including radiotherapy, chemotherapy, immunotherapy, and the use of bone marrow transplant. In a retrospective review, Coplin et al [2] identified cerebral hemorrhage or infarction in 36 out of 1245 patients (2.9%) undergoing bone marrow transplant. In patients with primary brain tumors, there may be vascular disorders related to the growth of the tumor, neovascularity, or tumor treatment. The cerebrovascular disorders associated with systemic cancer and primary central nervous system tumors are reviewed in this article, with an emphasis on the clinical presentation and tests that aid in the diagnosis. Identifying the disorder can lead to effective treatment and, in some patients, can lead to the diagnosis of cancer.