Chen Nan-Cheng, Liao Kuang-Ming, Tian Yu-Feng, Wu Yu-Cih, Wang Jhi-Joung, Ho Chung-Han, Hsu Chien-Chin
Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan, Taiwan.
Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
J Cancer. 2021 Sep 21;12(22):6749-6755. doi: 10.7150/jca.63184. eCollection 2021.
Breast cancer and stroke were leading cause of cancer-related mortality in the world. Stroke is the second leading cause of death. Previous studies showed that patients with breast cancer had a relatively higher risk of sleep disorders. Sleep disorders increased the risk of stroke. The aim of our study was to examine the risk of stroke after a breast cancer with sleep disorder among women in Taiwan. The Taiwan Cancer Registry was used to identify patients with breast cancer. Patients with new-onset breast cancer from January 2007 to December 2015 were selected for this study and followed until December 31, 2017. Patients who were diagnosed with sleep disorders were set as the case group, and the controls were those without sleep disorders. We enrolled 5256 patients with sleep disorders and 10,512 patients without sleep disorders. There were 121 (2.30%) patients with ischemic stroke among the breast cancer patients with sleep disorders. The mean time from the diagnosis of breast cancer to the occurrence of ischemic stroke was 6.29±2.59 years for breast cancer patients with sleep disorders and 6.00±2.76 years for those without sleep disorders (p < 0.0001). After matching by age and index year, breast patients with sleep disorders had a 1.31-fold higher risk (95% confidence interval: 1.03-1.66; p-value=0.026) of ischemic stroke than those without sleep disorders, after adjustment for comorbidities, cancer clinical stage, and treatment types. In conclusion, Breast cancer patients with sleep disorders have an increased risk of stroke.
乳腺癌和中风是全球癌症相关死亡的主要原因。中风是第二大死因。先前的研究表明，乳腺癌患者患睡眠障碍的风险相对较高。睡眠障碍会增加中风风险。我们研究的目的是调查台湾女性中患有睡眠障碍的乳腺癌患者发生中风的风险。利用台湾癌症登记处来识别乳腺癌患者。选取2007年1月至2015年12月新发乳腺癌患者进行本研究，并随访至2017年12月31日。被诊断为睡眠障碍的患者作为病例组，对照组为无睡眠障碍的患者。我们纳入了5256例有睡眠障碍的患者和10512例无睡眠障碍的患者。在患有睡眠障碍的乳腺癌患者中，有121例（2.30%）发生缺血性中风。患有睡眠障碍的乳腺癌患者从诊断乳腺癌到发生缺血性中风的平均时间为6.29±2.59年，无睡眠障碍的患者为6.00±2.76年（p<0.0001）。在按年龄和索引年份匹配后，在调整合并症、癌症临床分期和治疗类型后，患有睡眠障碍的乳腺癌患者发生缺血性中风的风险比无睡眠障碍的患者高1.31倍（95%置信区间：1.03-1.66；p值=0.026）。总之，患有睡眠障碍的乳腺癌患者中风风险增加。
