Department of Neurology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Department of Radiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Cancer Biother Radiopharm. 2019 Oct;34(8):504-510. doi: 10.1089/cbr.2019.2853. Epub 2019 Jul 11.
The present study aimed to retrospectively compare the clinical and imaging characteristics and laboratory data of patients with malignant tumor concurrent with acute ischemic stroke (IS) and patients with cerebral infarction only, and to analyze the potential related risk factors. A total of 126 patients with acute cerebral infarction concurrent with malignant tumor were collected and assigned to the malignant tumor group. In addition, 120 patients hospitalized for routine acute IS during the same period were randomly selected as the control group. Demographic data and common risk factors of cerebrovascular disease, laboratory data, and imaging characteristics in these two groups were compared. In the malignant tumor group, the age of onset was relatively low, and the National Institutes of Health Stroke Scale score, 90 d recurrence rate, and fatality rate were higher than for those in the control group ( < 0.05). However, most patients had no traditional risk factors of stroke. Biochemical results revealed that the peripheral hemoglobin of patients with malignant tumor and cerebral infarction was lower than for those in the control group ( < 0.05). Furthermore, the levels of D-dimer, fibrinogen, tumor markers CA125, CA199, and carcinoembryonic antigen were significantly elevated, and the difference was statistically significant ( < 0.05). Magnetic resonance imaging results revealed that multiple intracranial infarcts were more common in patients in the malignant tumor group, and the difference was statistically significant compared with patients with cerebral infarction only ( < 0.05). Patients with cancer and IS had fewer traditional stroke risk factors but more anemia as well as higher D-dimer level, tumor marker rate, short-term mortality, and stroke recurrence rate. Furthermore, lower age of onset and other characteristics, including multiple intracranial infarcts, can be regarded as important characteristics of such patients.
本研究旨在回顾性比较恶性肿瘤合并急性缺血性脑卒中（IS）患者与单纯脑梗死患者的临床、影像学特征和实验室数据，并分析潜在的相关危险因素。共收集 126 例急性脑梗死合并恶性肿瘤患者，设为肿瘤组。另外，同期随机选取 120 例因常规急性 IS 住院的患者作为对照组。比较两组患者的一般资料及常见脑血管病危险因素、实验室数据及影像学特征。肿瘤组发病年龄相对较低，NIHSS 评分、90d 复发率和病死率均高于对照组（ < 0.05）。但多数患者无传统脑卒中危险因素。生化结果显示，肿瘤组与对照组相比，外周血血红蛋白水平更低（ < 0.05）。此外，D-二聚体、纤维蛋白原、肿瘤标志物 CA125、CA199、癌胚抗原水平显著升高，差异有统计学意义（ < 0.05）。磁共振成像结果显示，肿瘤组患者颅内多发病灶更为常见，与单纯脑梗死患者比较，差异有统计学意义（ < 0.05）。恶性肿瘤合并 IS 患者具有较少的传统脑卒中危险因素，但更多贫血、更高的 D-二聚体水平、更高的肿瘤标志物阳性率、更高的短期病死率及更高的脑卒中复发率。此外，发病年龄较低及其他特征，包括多发病灶，可作为此类患者的重要特征。
