Clinical manifestation of cancer related stroke: retrospective case-control study
Clinical manifestation of cancer related stroke: retrospective case-control study
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DOI：
10.1007/s11060-012-1011-4
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发表时间：
2013-02-01
影响因子：
3.9
通讯作者：
Roh, Jae-Kyu
中科院分区：
文献类型：
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作者：
Kim, Jeong-Min;Jung, Keun-Hwa;Roh, Jae-Kyu
癌症相关卒中可能具有与非癌症卒中不同的表型，特别是在卒中进展和复发方面。我们进行了一项病例对照研究，以确定他们的发病率和危险因素在癌症相关的中风。2001年1月至2009年12月，我们对韩国首尔首尔国立大学医院收治的急性缺血性卒中伴癌症患者进行了回顾性分析。对照组为非癌症脑卒中患者。我们收集了人口统计学变量、血管危险因素、卒中表型、临床病程和癌症信息，包括诊断、分期和治疗状态。在癌症卒中患者中，评估卒中复发的潜在危险因素。102名癌症患者的平均年龄为66.4 ± 10.8岁，64.7%为男性。从癌症诊断到卒中发作的平均时间间隔为39.7 +/- A 60.9个月。癌性脑卒中的主要病变类型为单血管域多发性点状病变（39.2%），并伴有低血红蛋白和高纤维蛋白原水平。分别在9.8%和27.5%的癌症卒中患者和9.3%和12.7%的对照患者中观察到卒中进展和复发。经多元logistic回归分析，卒中亚型与癌症卒中复发独立相关（比值比= 3.165，95%置信区间= 1.080-9.277，p = 0.036）。癌症相关卒中在梗死模式和实验室检查结果方面具有独特的表型。脑卒中复发是癌症脑卒中患者的常见现象，其危险性与脑卒中亚型有关。
Cancer related stroke may have different phenotypes from non-cancer stroke, especially in terms of stroke progression and recurrence. We performed a case-control study to identify their incidences and risk factors in cancer related stroke. Between January 2001 and December 2009, we conducted a retrospective review of acute ischemic stroke patients with cancer who were admitted to Seoul National University Hospital, Seoul, Korea. The stroke patients without cancer served as control. We collected demographic variables, vascular risk factors, stroke phenotype, clinical course, and cancer information including diagnosis, stage, and treatment status. Among cancer stroke patients, the potential risk factor of stroke recurrence was evaluated. The mean age of the 102 cancer patients was 66.4 +/- A 10.8 years, and 64.7 % were men. The mean time interval from cancer diagnosis to stroke onset was 39.7 +/- A 60.9 months. The principal lesion pattern of cancer stroke was multiple dots extending single vascular territory (39.2 %), and they were associated with low hemoglobin and high fibrinogen levels. Stroke progression and recurrence were noted in 9.8 and 27.5 % of cancer stroke patients, and in 9.3 and 12.7 % of control patients, respectively. The stroke subtype was independently associated with recurrence of cancer stroke after multiple logistic regression (odds ratio = 3.165, 95 % confidence interval = 1.080-9.277, p = 0.036). Cancer related stroke has a distinct phenotype in terms of infarction pattern and laboratory findings. Stroke recurrence is frequently observed among cancer stroke patients, and its risk is related with stroke subtype.