Clinical characteristics and risk factors of gastric cancer-related stroke

doi:10.3969/j.issn.1004-583X.2023.05.005

Abstract

Abstract:

Objective To investigate the clinical characteristics and risk factors of patients with gastric cancer-related stroke (GCS). Methods A total of 42 patients with gastric cancer who were diagnosed in the Fourth Hospital of Hebei Medical University from January 2014 to December 2019 and had new cerebral infarction in the course of diagnosis and treatment were included in GCS group. During the same period, eighty-four gastric cancer patients without new cerebral infarction occurred in the course of diagnosis and treatment were included in the control group. Clinical data and characteristics between groups were compared, and those with significant differences were introduced into the multivariate logistic regression analysis to analyze independent risk factors for new cerebral infarction in gastric cancer patients. Results A total of 42 GCS patients with the mean age of 67.14±8.15 (47-86) years were collected in this study, including 34 males and 8 female. They were pathologically diagnosed as gastric adenocarcinomas. Cerebral infarction occurred 0-985 days after the diagnosis of gastric cancer, with the median onset time of 38 days. Magnetic resonance imaging (MRI) showed that 22 cases (52.4%) had multiple lesions and multiple sites involved in the brain, and 25 cases (59.5%) did not receive targeted treatment for gastric cancer because of cerebral infarction. The proportion of hypertension history, diabetes history, hyperlipidemia history and previous cerebral infarction history in GCS group was significantly higher than that in the control group (P<0.05). The prothrombin time, D-dimer and carbohydrate antigen 199 levels in GCS group were significantly higher than those in the control group, while the hemoglobin level was significantly lower than that in the control group (P<0.05). The proportion of patients with surgical history and chemotherapy history in the GCS group was significantly lower than that in the control group (P<0.05). Multivariate logistic regression analysis showed that a previous history of cerebral infarction was an independent risk factor for cerebral infarction in GCS patients. Conclusion Cerebral infarction is highly prevalent within 1-6 months after the diagnosis of gastric cancer. Conventional risk factors for stroke are also independent risk factors for stroke in gastric cancer patients, so as the history of cerebral infarction. Our findings have a important guiding significance for preventing and reducing the occurrence of GCS.

Key words: stomach neoplasms, brain infarction, CA-199, risk factors

CLC Number:

R735.2

Wang Yingnan, Zhao Qi, Bai Haiwei, Wu Danna, Wei Jinmei, Li Shengjiang, Li Ruiling, Zhang Ruixing. Clinical characteristics and risk factors of gastric cancer-related stroke[J]. Clinical Focus, 2023, 38(5): 417-422.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.05.005

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I5/417

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References 23

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组别	例数		性别				年龄					高血压史				糖尿病史
组别	例数		男		女		≤60岁			>60岁		有		无		有		无
GCS组	42		34(81.0)		8(19.0)		9(21.4)			33(78.6)		21(50.0)		21(50.0)		12(28.6)		30(71.4)
对照组	84		68(81.0)		16(19.0)		24(28.6)			60(71.4)		23(27.4)		61(72.6)		6(7.1)		78(92.9)
χ²值			0.000				0.739					6.303				10.500
P值			1.000				0.390					0.012				0.001
组别		高脂血症史				冠心病史			吸烟史				饮酒史				既往脑梗死史
组别		有		无		有		无	有		无		有		无		有		无
GCS组		9(21.4)		33(78.6)		8(19.0)		34(81.0)	18(42.9)		24(57.1)		13(31.0)		29(69.0)		23(54.8)		19(45.2)
对照组		3(3.6)		81(96.4)		10(11.9)		74(88.1)	37(44.0)		47(56.0)		29(34.5)		55(65.5)		6(7.1)		78(92.9)
χ²值		8.393				1.167			0.016				0.161				35.834
P值		0.004				0.280			0.899				0.688				0.000

组别	例数		性别				年龄					高血压史				糖尿病史
组别	例数		男		女		≤60岁			>60岁		有		无		有		无
GCS组	42		34(81.0)		8(19.0)		9(21.4)			33(78.6)		21(50.0)		21(50.0)		12(28.6)		30(71.4)
对照组	84		68(81.0)		16(19.0)		24(28.6)			60(71.4)		23(27.4)		61(72.6)		6(7.1)		78(92.9)
χ²值			0.000				0.739					6.303				10.500
P值			1.000				0.390					0.012				0.001
组别		高脂血症史				冠心病史			吸烟史				饮酒史				既往脑梗死史
组别		有		无		有		无	有		无		有		无		有		无
GCS组		9(21.4)		33(78.6)		8(19.0)		34(81.0)	18(42.9)		24(57.1)		13(31.0)		29(69.0)		23(54.8)		19(45.2)
对照组		3(3.6)		81(96.4)		10(11.9)		74(88.1)	37(44.0)		47(56.0)		29(34.5)		55(65.5)		6(7.1)		78(92.9)
χ²值		8.393				1.167			0.016				0.161				35.834
P值		0.004				0.280			0.899				0.688				0.000

组别	例数	WBC计数 (×10⁹/L)	NEUT (×10⁹/L)	RBC计数 (×10¹²/L)	HGB (g/L)	PLT (×10⁹/L)	MPV (fL)	PT (s)	APTT (s)	FIB (g/L)	D-D (μg/ml)
GCS组	42	7.81±3.81	5.93±3.88	3.65±0.69	105.11±21.97	226.83±104.54	8.20±1.48	12.13±1.55	28.61±5.27	3.43±0.83	1.98±2.78
对照组	84	7.08±5.03	5.03±4.81	3.88±0.60	113.61±20.89	231.58±94.28	7.77±1.09	11.59±1.17	30.42±4.95	3.44±0.84	0.82±1.84
t值		0.829	1.051	-1.956	-2.116	-0.257	1.809	2.201	-1.894	-0.013	2.463
P值		0.409	0.295	0.053	0.036	0.798	0.073	0.030	0.061	0.990	0.017

组别	例数	WBC计数 (×10⁹/L)	NEUT (×10⁹/L)	RBC计数 (×10¹²/L)	HGB (g/L)	PLT (×10⁹/L)	MPV (fL)	PT (s)	APTT (s)	FIB (g/L)	D-D (μg/ml)
GCS组	42	7.81±3.81	5.93±3.88	3.65±0.69	105.11±21.97	226.83±104.54	8.20±1.48	12.13±1.55	28.61±5.27	3.43±0.83	1.98±2.78
对照组	84	7.08±5.03	5.03±4.81	3.88±0.60	113.61±20.89	231.58±94.28	7.77±1.09	11.59±1.17	30.42±4.95	3.44±0.84	0.82±1.84
t值		0.829	1.051	-1.956	-2.116	-0.257	1.809	2.201	-1.894	-0.013	2.463
P值		0.409	0.295	0.053	0.036	0.798	0.073	0.030	0.061	0.990	0.017

肿瘤标记物	组别	CEA(ng/ml)	AFP(ng/ml)	CA-199(U/ml)	CA-724(U/ml)
GCS组	42	39.31±68.25	7.93±20.95	185.03±317.85	81.43±229.18
对照组	84	84.28±240.41	11.33±54.93	83.82±197.54	12.75±36.72
t值		-1.591	-0.387	2.195	1.930
P值		0.115	0.699	0.030	0.060