Huang Gelun, Chen Li, Qin Chao, Cheng Daobin, Lu Qiuhong, Yu Lixia, Liang Zhijian
a Department of Neurology , First Affiliated Hospital of Guangxi Medical University , Nanning , China.
Int J Neurosci. 2018 Jan;128(1):48-54. doi: 10.1080/00207454.2017.1357553. Epub 2017 Aug 1.
Cerebral hemorrhage as well as ischemic stroke is one of the common complications among patients with cancer. Ischemic stroke could be the initial manifestation in some patients with cancer. Meanwhile, some patients with cancer also could present cerebral hemorrhage as the initial manifestation, and further studies are required to determine whether these patients have their unique clinical features.
To investigate the clinical features and underlying pathogenesis of concealed systemic cancer patients with cerebral hemorrhage as the initial manifestation.
The clinical data of patients with concealed systemic cancer who presented cerebral hemorrhage as the initial manifestation registered at the First Affiliated Hospital of Guangxi Medical University from January 2010 to December 2015 were prospectively collected and analyzed.
Seventeen systemic cancer patients with cerebral hemorrhage as the initial manifestation (0.02%) were ultimately enrolled from 8,326 patients with cerebral hemorrhage. Three patients had traditional risk factors, but the other 14 patients did not. The common subtypes of malignancy were lung cancer, liver cancer, gastric carcinoma, rectal cancer and melanoma. Most patients (11/17, 64.7%) had elevated plasma levels of cancer biochemical markers, including cancer antigen (CA)125, CA153 and CA199, carcino-embryonic antigen, and alpha fetal protein. Coagulopathy was observed in 15 patients.
The concealed systemic cancer patients with cerebral hemorrhage as the initial manifestation may lack conventional vascular risk factors but did present coagulopathy and elevated plasma levels of cancer biochemical markers. Coagulopathy might be responsible for the cerebral hemorrhage.
脑出血以及缺血性脑卒中是癌症患者常见的并发症之一。缺血性脑卒中可能是一些癌症患者的首发表现。同时，一些癌症患者也可能以脑出血为首发表现，需要进一步研究来确定这些患者是否有其独特的临床特征。
探讨以脑出血为首发表现的隐匿性全身癌症患者的临床特征及潜在发病机制。
前瞻性收集并分析2010年1月至2015年12月在广西医科大学第一附属医院登记的以脑出血为首发表现的隐匿性全身癌症患者的临床资料。
在8326例脑出血患者中，最终纳入17例以脑出血为首发表现的全身癌症患者（0.02%）。3例患者有传统危险因素，其余14例没有。恶性肿瘤的常见亚型为肺癌、肝癌、胃癌、直肠癌和黑色素瘤。大多数患者（11/17，64.7%）血浆中癌症生化标志物水平升高，包括癌抗原（CA）125、CA153和CA199、癌胚抗原和甲胎蛋白。15例患者出现凝血功能障碍。
以脑出血为首发表现的隐匿性全身癌症患者可能缺乏传统的血管危险因素，但确实存在凝血功能障碍和血浆中癌症生化标志物水平升高。凝血功能障碍可能是脑出血的原因。
