癌症幸存者的中风风险：一项荟萃分析和荟萃回归

Stroke risk in cancer survivors: A meta-analysis and meta regression.

作者信息

de Moraes Francisco Cezar Aquino, Matheus Gustavo Tadeu Freitas Uchôa, Souza Maria Eduarda Cavalcanti, de Almeida Artur Menegaz, Gonçalves Ocílio de Deus da Rocha Ribeiro, Silva Anna Lydia Machado, Padilha Lucas Bresciani, Kelly Francinny Alves, Burbano Rommel Mario Rodríguez

机构信息

Federal University of Pará, Belém, Pará, 66073-005, Brazil.

Federal University of Triângulo Mineiro, Uberaba, 38025-180, Brazil.

出版信息

Neurol Sci. 2025 Sep 19. doi: 10.1007/s10072-025-08502-2.

DOI:10.1007/s10072-025-08502-2

PMID:40968352

Abstract

INTRODUCTION

It is suggested that survivors of different types of cancer may have an increased risk of stroke. Our study aims to evaluate cancer patients and non-cancer controls by analyzing stroke events in each group. Previous studies concluded that certain types of cancer increased stroke risk, however, their results had significant heterogeneity and statistical concerns.

METHODS

Medline, Embase, and Cochrane databases were systematically searched until February 18th, 2024, assessing stroke in cancer survivor patients compared to the global population. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was assessed using I² statistics. Rstudio software, version 4.2.3., was used for statistical analysis.

RESULTS

A total of 18 studies were included, and stroke was reported in both cancer and non-cancer groups. Breast cancer (HR 1.09; 95% CI 1.02-1.17; p = 0.01; I²= 0%), Central Nervous System cancers (HR 2.47; 95% CI 1.01-6.01; p = 0.047; I²= 78%), cervical cancers (HR 1.58; 95% CI 1.19-2.09; p = 0.001; I²= 0%), head and neck cancers (HR 1.4439; 95% CI 1.3095-1.5922; p < 0.001; I²=31.5%), lung cancers (HR 1.60; 95% CI 1.40-1.83; p < 0.001; I²=67%), multiple myeloma (HR 1.58; 95% CI 1.32-1.89; p < 0.001; I²= 49%), nasopharyngeal cancers (HR 1.9178; 95% CI 1.3358-2.7533; p < 0.001; I²=89.7%), oesophageal cancers (HR 1.33; 95% CI 1.07-1.65; p = 0.009; I²= 0%), ovarian cancers (HR 1.33; 95% CI 1.07-1.65; p = 0.01; I²= 38%), pancreatic cancers (HR 2,70; 95% CI 2.34-3.11; p < 0.001; I²= 0%) and rectum cancers (HR 1.29; 95% CI 1.01-1.63; p = 0.04; I²= 0%) showed statistically significant differences between groups in favor of non-cancer controls.

CONCLUSIONS

In this meta-analysis, the stroke risk was increased in all cancers that reached statistical significance. Furthermore, our study brings relevant data to the body of literature concerning this long-term clinical uncertainty.

摘要

引言

有研究表明，不同类型癌症的幸存者患中风的风险可能会增加。我们的研究旨在通过分析每组中的中风事件来评估癌症患者和非癌症对照组。以往的研究得出结论，某些类型的癌症会增加中风风险，然而，他们的研究结果存在显著的异质性和统计学问题。

方法

系统检索了Medline、Embase和Cochrane数据库，直至2024年2月18日，评估癌症幸存者患者与全球人群相比的中风情况。使用Mantel-Haenszel方法和95%置信区间对数据进行检验。使用I²统计量评估异质性。使用Rstudio软件版本4.2.3进行统计分析。

结果

共纳入18项研究，癌症组和非癌症组均报告了中风情况。乳腺癌（风险比1.09；95%置信区间1.02 - 1.17；p = 0.01；I² = 0%）、中枢神经系统癌症（风险比2.47；95%置信区间1.01 - 6.01；p = 0.047；I² = 78%）、宫颈癌（风险比1.58；95%置信区间1.19 - 2.09；p = 0.001；I² = 0%）、头颈癌（风险比1.4439；95%置信区间1.3095 - 1.5922；p < 0.001；I² = 31.5%）、肺癌（风险比1.60；95%置信区间1.40 - 1.83；p < 0.001；I² = 67%）、多发性骨髓瘤（风险比1.58；95%置信区间1.32 - 1.89；p < 0.001；I² = 49%）、鼻咽癌（风险比1.9178；95%置信区间1.3358 - 2.7533；p < 0.001；I² = 89.7%）、食管癌（风险比1.33；95%置信区间1.07 - 1.65；p = 0.009；I² = 0%）、卵巢癌（风险比1.33；95%置信区间1.07 - 1.65；p = 0.01；I² = 38%）、胰腺癌（风险比2.70；95%置信区间2.34 - 3.11；p < 0.001；I² = 0%）和直肠癌（风险比1.29；95%置信区间1.01 - 1.63；p = 0.04；I² = 0%）在组间显示出统计学上的显著差异，支持非癌症对照组。