Shichijo Chika, Kai Keita, Jinnouchi Kazuki, Nishihara Masashi, Hara Hideo, Aishima Shinichi
Department of Pathology & Microbiology, Saga University Faculty of Medicine, Saga 849-8501, Japan.
Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine, Saga 849-8501, Japan.
Cancers (Basel). 2021 Oct 19;13(20):5234. doi: 10.3390/cancers13205234.
Cerebral infarction (CI) severely affects the prognosis of patients with malignancy. The aim of the study was to compare the pathology of CI between cases with and without malignancy focusing on intracranial Mönckeberg's atherosclerosis. Among 778 autopsy cases of craniotomy, 53 cases of "cerebral infarction without malignancy group" (CI group), 50 cases of "malignant tumor without CI group" (MT group), and 39 cases of "cerebral infarction with malignancy group" (CM group) were identified. Mönckeberg's atherosclerosis was mainly found in the basal ganglia and its prevalence in the CM group (38.5%) was significantly higher than in the MT group (12.0%, = 0.005), and apparently higher than in the CI group (18.9%, = 0.057). The CI group was significantly older, had higher BMIs, and a greater prevalence of hypertension and atrial fibrillation compared to the CM group. In addition, the prevalence of chronic renal disease was significantly lower in the CM group (2.6%, = 0.012) than in the CI group (20.8%). Our results indicated that Mönckeberg's atherosclerosis was often found in the basal ganglia of CM cases and that intracranial Mönckeberg's atherosclerosis is a potential risk factor for CI in patients with advanced stage malignancy.
脑梗死(CI)严重影响恶性肿瘤患者的预后。本研究旨在比较有无恶性肿瘤病例的CI病理学情况,重点关注颅内蒙克贝格动脉硬化。在778例开颅尸检病例中,确定了53例“无恶性肿瘤脑梗死组”(CI组)、50例“无CI恶性肿瘤组”(MT组)和39例“有恶性肿瘤脑梗死组”(CM组)。蒙克贝格动脉硬化主要见于基底节,其在CM组中的患病率(38.5%)显著高于MT组(12.0%,P = 0.005),且明显高于CI组(18.9%,P = 0.057)。与CM组相比,CI组年龄显著更大,体重指数更高,高血压和心房颤动的患病率更高。此外,CM组慢性肾病的患病率(2.6%,P = 0.012)显著低于CI组(20.8%)。我们的结果表明,CM病例的基底节常发现蒙克贝格动脉硬化,颅内蒙克贝格动脉硬化是晚期恶性肿瘤患者发生CI的潜在危险因素。