Ischemic Stroke In Patients With Malignant Tumor

Objective This study aimed to investigate the clinical features of patients with malignant tumor complicated with cerebral infarction, including cerebrovascular risk factors, etiology and typing, clinical symptoms and signs, laboratory results, imaging features, pathological types of tumor, diagnosis, therapy for tumor, prognosis and so on, and to explore the risk factors of cerebral infarction in patients with malignant tumors.Methods A retrospective review of all stroke patients with cancer (n=63)admitted to The First Affiliated Hospital of Guangxi Medical University andAffiliated Tumor Hospital of Guangxi Medical University From January2006toDecember2010was conducted. Comparison was made to age, gender, time ofonset and tumor type matched non-cancer stroke patients and non-stroke cancerpatients admitted to the same hospital during the same period. At the same time,multiple logistic regression analysis was used to analysis the results.Results This study collected19kinds of tumor related cerebralinfarction, in which lung cancer is the most common, accounting for28.57%,proportion of metastatic cancer, accounting for47.62%. This study found thattraditional cerebrovascular risk factors has no significant difference among thethree groups. Changes of blood components and coagulation disorders may bethe factors of cerebral infarction in tumor patients. A simple red blood cell count and hemoglobin of cancer patients with cerebral infarction wassignificantly lower (P <0.05), platelet count and mean platelet volume have alsochanged. The multivariate analysis found that the platelet count is a risk factorfor cerebral infarction with cancer. While platelet count increased by1×109mol/L, the probability of cerebral infarction with malignancy wasincreased by about1.3%(OR,1.013;95%CI,1.005-1.022; P≈0.002). Compared with simple cerebral infarction group, thrombin time (TT),prothrombin time (PT) extended, activated partial thromboplastin time (APTT)shorten in the cerebral infarction group. APTT is a protective factor for cancerpatients with cerebral infarction,1s of its reducing cause the increasingmorbility of cerebral infarction by15.4%(OR,0.846;95%CI,0.771-0.929; P≈0.000). In addition, surgical treatment is one of the factors causing cerebralinfarction in tumor patients. The risk of cerebral infarction in tumors patientswho have received surgical treatment is3.894times more than the cancerpatients who did not receive (OR,3.894;95%CI,1.717-8.831; P=0.001). Inthis study, cryptogenic stroke (41.27%) is the most common etiology typing ofcerebral infarction in malignant tumors patients. The neurological symptoms andsigns in malignancies patients with cerebral infarction are similar with patientswho have cerebral infarction alone. In the tumor with cerebral infarction group,complications are serious, and thrombotic events are more common. Most tumorpatients with cerebral infarction died in hospital, the prognosis is poor.Conclusions Cryptogenic cerebral infarction is commen in tumor patients.Blood system and Coagulation disorders are more likely to be seen in strokepatients with cancer, and complications in these patients are more serious.Patients with cancer have a higher in-hospital post-stroke mortality. Bloodsystem abnormalities, coagulation disorders and surgical therapy may be risk factors for cerebral infarction in patients with malignant tumors.