Colla Machado Pedro E, Pappolla Agustín, Alonzo Claudia, Brescacin Laura, Heriz Alejandra N, Horsch Andrea, Payares Utria Idaira, Anrriquez Federico, Sosa Albacete Federico, Justich María B, Balian Natalia R, Zurrú María C
Servicio de Neurología, Hospital Italiano de Buenos Aires, Argentina. E-mail:
Servicio de Neurología, Hospital Italiano de Buenos Aires, Argentina.
Medicina (B Aires). 2020;80(5):442-446.
One in 10 patients with ischemic stroke has comorbid cancer. Our goal was to compare stroke patients with cancer against those without cancer in terms of clinical and radiological features, and the underlying mechanism. We conducted a retrospective case-control study in patients admitted with ischemic stroke between July 2013 and September 2018. Cases had a concomitant diagnosis of cancer and acute ischemic stroke, controls only of ischemic stroke. Age, gender, vascular risk factors (VRF), pattern of ischemic lesion in neuroimaging, etiology and clinical outcome were compared between groups. Fifty-seven cases were identified, 61% were male (n = 35), and mean age was 75 ± 11. Fiftytwo had known oncologic disease at the onset of stroke. Most of them had solid tumors (91%, n = 52), and 54% (n = 31) had a non-metastatic tumor at the time of stroke. Prevalence of common VRF between groups was not significantly different. Previous deep venous thrombosis and pulmonary thromboembolism were more frequent in the cancer cohort (8% vs. 1%, p = 0.01). The average NIHSS was 3.8 ± 4 in the cancer group and 9 ± 7 in the control group (p = 0.01). Small artery disease as the etiology of stroke was significantly less common in the cancer group (2% vs. 26%, p = 0.001). Regarding neuroimaging, the embolic pattern was more frequent in patients with cancer (82% vs. 35%, p = 0.001). In these patients recurrence and mortality at 90 days was three and six times higher (10% vs. 3%, and 18% vs. 3%. p = 0.08 and 0.001, respectively).
每10名缺血性中风患者中就有1人合并癌症。我们的目标是比较患有癌症的中风患者与未患癌症的中风患者在临床和放射学特征以及潜在机制方面的差异。我们对2013年7月至2018年9月期间收治的缺血性中风患者进行了一项回顾性病例对照研究。病例组为同时患有癌症和急性缺血性中风的患者,对照组仅为缺血性中风患者。比较了两组患者的年龄、性别、血管危险因素(VRF)、神经影像学缺血性病变模式、病因及临床结局。共确定了57例病例,其中61%为男性(n = 35),平均年龄为75±11岁。52例在中风发作时已知患有肿瘤疾病。其中大多数患有实体瘤(91%,n = 52),54%(n = 31)在中风时患有非转移性肿瘤。两组间常见VRF的患病率无显著差异。癌症队列中既往深静脉血栓形成和肺血栓栓塞更为常见(8%对1%,p = 0.01)。癌症组的平均美国国立卫生研究院卒中量表(NIHSS)评分为3.8±4,对照组为9±7(p = 0.01)。癌症组中作为中风病因的小动脉疾病明显较少见(2%对26%,p = 0.001)。在神经影像学方面,癌症患者的栓塞模式更为常见(82%对35%,p = 0.001)。这些患者90天时的复发率和死亡率分别高出3倍和6倍(分别为10%对3%,18%对3%,p = 0.08和0.001)。