Motataianu Anca, Maier Smaranda, Andone Sebastian, Barcutean Laura, Serban Georgiana, Bajko Zoltan, Balasa Adrian
George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures Targu Mures, Romania.
Emergency County Hospital Targu Mures, Romania.
J Crit Care Med (Targu Mures). 2021 Jan 29;7(1):54-61. doi: 10.2478/jccm-2021-0002. eCollection 2021 Jan.
An increasing trend of cancer associated stroke has been noticed in the past decade.
To evaluate the risk factors and the incidence of neoplasia in stroke patients.
A retrospective, observational study was undertaken on 249 patients with stroke and active cancer (SAC) and 1563 patients with stroke without cancer (SWC). The general cardiovascular risk factors, the site of cancer, and the general clinical data were registered and evaluated. According to the "Oxfordshire Community Stroke Project" (OCSP) classification, all patients were classified into the clinical subtypes of stroke. The aetiology of stroke was considered as large-artery atherosclerosis, small vessel disease, cardio-embolic, cryptogenic or other determined cause.
The severity of neurological deficits at admission were significantly higher in the SAC group (p<0.01). The haemoglobin level was significantly lower, and platelet level and erythrocyte sedimentation rate were significantly higher in the SAC group. Glycaemia, cholesterol and triglycerides levels were significantly higher in the SWC group. The personal history of hypertension was more frequent in the SWC group. In the SAC group, 28.9% had a cryptogenic aetiology, compared to 9.1% in SWC group. Cardio-embolic strokes were more frequent in the SAC group (24%) than the SWC group (19.6%). In the SAC group, 15,6% were diagnosed with cancer during the stroke hospitalization, and 78% of the SAC patients were without metastasis.
The most frequent aetiologies of stroke in cancer patients were cryptogenic stroke, followed by large-artery atherosclerosis. SAC patients had more severe neurological deficits and worse clinical outcomes than SWC patients. Stroke in cancer patients appears to be more frequently cryptogenic, probably due to cancer associated thrombosis. The association between stroke and cancer is important, especially in stroke of cryptogenic mechanism, even in the presence of traditional cardiovascular risk factors.
在过去十年中，癌症相关性卒中的趋势呈上升态势。
评估卒中患者的危险因素及肿瘤形成的发生率。
对249例患有卒中且患有活动性癌症（SAC）的患者和1563例患有卒中但无癌症（SWC）的患者进行了一项回顾性观察研究。记录并评估了一般心血管危险因素、癌症部位及一般临床资料。根据“牛津郡社区卒中项目”（OCSP）分类，将所有患者分为卒中的临床亚型。卒中病因被认为是大动脉粥样硬化、小血管疾病、心源性栓塞、隐源性或其他确定病因。
SAC组入院时神经功能缺损的严重程度明显更高（p<0.01）。SAC组血红蛋白水平明显更低，血小板水平和红细胞沉降率明显更高。SWC组血糖、胆固醇和甘油三酯水平明显更高。SWC组高血压个人史更常见。在SAC组中，28.9%的患者病因不明，而SWC组为9.1%。SAC组心源性栓塞性卒中（24%）比SWC组（19.6%）更常见。在SAC组中，15.6%的患者在卒中住院期间被诊断患有癌症，78%的SAC患者无转移。
癌症患者中最常见的卒中病因是隐源性卒中，其次是大动脉粥样硬化。SAC组患者的神经功能缺损比SWC组患者更严重，临床结局更差。癌症患者的卒中似乎更常为隐源性，可能是由于癌症相关血栓形成。卒中和癌症之间的关联很重要，尤其是在隐源性机制的卒中中，即使存在传统心血管危险因素时亦是如此。
