Wu Jielong, Hong Ganji, Zheng Liangcheng, Zhao Jiedong, Yu Lu, Jing Chuya, Zhang Qiuhong, Wang Chen, Yuan Xiaodong, Lin Qing, Wang Zhanxiang, Ma Qilin, Fang Jie
Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China.
National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China.
Stroke Vasc Neurol. 2024 Nov 11. doi: 10.1136/svn-2024-003287.
The incidence of cancer-associated ischaemic stroke (IS) is increasingly prevalent. This study aimed to assess the levels of enlarged perivascular spaces in basal ganglion (BG-EPVS) in cancer-associated patients who had a stroke compared with the control group, and to investigate the diagnostic utility of BG-EPVS in the context of cancer-associated stroke.
A matched case-control study was conducted in Xiamen, China. A total of 184 IS patients (cancer vs control=1:1) were recruited. The severity of BG-EPVS was graded using high-resolution MRI. Patients' gender, age, clinical risk factors, other imaging changes and laboratory findings information at admission were collected. Logistic regression models were constructed and subgroup analysis by cancer treatment.
Overall, 65.22% of the 184 subjects were male, with a mean (SD) age of 68.83±10.52 years. BG-EPVS had a significant influence on cancer-associated stroke (OR=1.85 (95% CI 1.29, 2.71), p=0.001) after adjusting for gender, age, clinical risk factors, other imaging changes and laboratory findings. The area under the curve of the diagnosis model that combined BG-EPVS and other factors was 0.848 (95% CI 0.787, 0.896), significantly higher than the other three models. Subgroup analysis suggested a heightened association between BG-EPVS and cancer-associated stroke within the cancer treatment group.
In conclusion, this is the first study to assess the diagnosis values of BG-EPVS on cancer-associated stroke and helps us understand the pathogenesis of cancer-associated stroke. Our findings demonstrate the effectiveness of BG-EPVS in diagnosing IS patients who may carry underlying cancer.
癌症相关性缺血性卒中（IS）的发病率日益普遍。本研究旨在评估与对照组相比，发生卒中的癌症相关性患者基底节区血管周围间隙增宽（BG-EPVS）的水平，并探讨BG-EPVS在癌症相关性卒中背景下的诊断效用。
在中国厦门进行了一项匹配病例对照研究。共招募了184例IS患者（癌症患者与对照组比例为1:1）。使用高分辨率MRI对BG-EPVS的严重程度进行分级。收集患者入院时的性别、年龄、临床危险因素、其他影像学改变及实验室检查结果信息。构建逻辑回归模型并按癌症治疗情况进行亚组分析。
总体而言，184名受试者中65.22%为男性，平均（标准差）年龄为68.83±10.52岁。在调整了性别、年龄、临床危险因素、其他影像学改变及实验室检查结果后，BG-EPVS对癌症相关性卒中具有显著影响（比值比=1.85（95%置信区间1.29，2.71），p=0.001）。结合BG-EPVS和其他因素的诊断模型的曲线下面积为0.848（95%置信区间0.787，0.896），显著高于其他三个模型。亚组分析表明，癌症治疗组中BG-EPVS与癌症相关性卒中之间的关联更强。
总之，这是第一项评估BG-EPVS对癌症相关性卒中诊断价值的研究，有助于我们理解癌症相关性卒中的发病机制。我们的研究结果证明了BG-EPVS在诊断可能患有潜在癌症的IS患者中的有效性。
