AIM To investigate the specific biomarkers and potential pathogenesis of colorectal cancer-related ischemic stroke(CRCIS).METHODS A retrospective study was conducted on CRCIS patients(colorectal cancer patients with i...AIM To investigate the specific biomarkers and potential pathogenesis of colorectal cancer-related ischemic stroke(CRCIS).METHODS A retrospective study was conducted on CRCIS patients(colorectal cancer patients with ischemic stroke without conventional stroke risk factors) registered at seven centers between January 2007 and December 2017. Clinical data and laboratory and imaging findings were compared with age-and sex-matched patients with colorectal cancer(CRC) without ischemic stroke that were admitted to the same hospital during the same period. Univariate and multivariate analyses were performed to analyze the independent risk factors for CRCIS. A receiver operator characteristic curve was configured to calculate the optimal cut-off value of the products of the independent risk factors for CRCIS. RESULTS A total of 114 CRCIS patients and 114 CRC patients were included. Multiple lesions in multiple vascular territories were common in CRCIS patients(71, 62.28%). The levels of plasma D-dimer, carcinoembryonic antigen(CEA), cancer antigen 125, and neutrophil count were significantly higher in CRCIS patients than in CRC patients. Multiple logistic regression analysis revealed that plasma D-dimer levels [odds ratio(OR) = 1.002, 95% confidence interval(CI): 1.001-1.003, P < 0.001], CEA levels(OR = 1.011, 95%CI: 1.006-1.015, P < 0.001), and neutrophil count levels(OR = 1.626, 95%CI: 1.268-2.087, P < 0.001) were independent risk factors for CRCIS. In addition, receiver operator characteristic curve revealed that the area under curve for the products of plasma D-dimer, CEA, and neutrophil count was 0.889 ± 0.022(95%CI: 0.847-0.932, P < 0.001), and the optimal cut-off value for the product was 252.06, which was called the CRCIS Index, with a sensitivity of 86.0% and specificity of 79.8%.CONCLUSION Hypercoagulability induced by elevated CEA and neutrophils may be an important cause of CRCIS. The CRCIS index, which serves as a biomarker of CRCIS, needs further study.展开更多
BACKGROUND The diagnosis of both cancer and intracerebral hemorrhage(ICH)in the same patient is not uncommon,but the clinical features and pathogenesis of patients with colorectal cancer(CRC)and ICH are still not well...BACKGROUND The diagnosis of both cancer and intracerebral hemorrhage(ICH)in the same patient is not uncommon,but the clinical features and pathogenesis of patients with colorectal cancer(CRC)and ICH are still not well known.AIM To investigate the clinical features and underlying pathogenesis of ICH in patients with CRC.METHODS A retrospective review of CRC patients complicated with ICH from three centers between January 2014 and December 2020 was performed.Clinical data such as laboratory examinations,imaging features,prognosis,and underlying pathogenesis were analyzed.RESULTS Of 16673 identified CRC patients,20(0.12%)suffered from ICH.There were 13 males and 7 females,with an average age(mean±SD)of 68.45±10.66 years.Fourteen patients(70%)had distant metastases and most patients(85%)showed an elevation of one or more cancer biomarkers.The hemorrhagic lesions in 13 patients(65%)were in the intracerebral lobe.Four patients were completely dependent and 4 died within 30 days after hemorrhage.Intratumoral hemorrhage(50%)and coagulopathy(50%)accounted for the majority of hemorrhages.CONCLUSION Patients with ICH and CRC often have clinical features with lobar hemorrhage,distant metastases and poor prognosis.Intratumoral hemorrhage and coagulopathy are the main causes of ICH in patients with CRC.展开更多
基金the Guangxi Natural Science Foundation,No.2015GXNSFAA139228 and No.2016GXNSFAA380281Guangxi Medical and Health and Appropriate Technology Development and Promotion Application Project,No.S201660+1 种基金Innovation Project of Guangxi Graduate Education,No.YCSW2018105National Key Research and Development Program,No.2018YFC1311300
文摘AIM To investigate the specific biomarkers and potential pathogenesis of colorectal cancer-related ischemic stroke(CRCIS).METHODS A retrospective study was conducted on CRCIS patients(colorectal cancer patients with ischemic stroke without conventional stroke risk factors) registered at seven centers between January 2007 and December 2017. Clinical data and laboratory and imaging findings were compared with age-and sex-matched patients with colorectal cancer(CRC) without ischemic stroke that were admitted to the same hospital during the same period. Univariate and multivariate analyses were performed to analyze the independent risk factors for CRCIS. A receiver operator characteristic curve was configured to calculate the optimal cut-off value of the products of the independent risk factors for CRCIS. RESULTS A total of 114 CRCIS patients and 114 CRC patients were included. Multiple lesions in multiple vascular territories were common in CRCIS patients(71, 62.28%). The levels of plasma D-dimer, carcinoembryonic antigen(CEA), cancer antigen 125, and neutrophil count were significantly higher in CRCIS patients than in CRC patients. Multiple logistic regression analysis revealed that plasma D-dimer levels [odds ratio(OR) = 1.002, 95% confidence interval(CI): 1.001-1.003, P < 0.001], CEA levels(OR = 1.011, 95%CI: 1.006-1.015, P < 0.001), and neutrophil count levels(OR = 1.626, 95%CI: 1.268-2.087, P < 0.001) were independent risk factors for CRCIS. In addition, receiver operator characteristic curve revealed that the area under curve for the products of plasma D-dimer, CEA, and neutrophil count was 0.889 ± 0.022(95%CI: 0.847-0.932, P < 0.001), and the optimal cut-off value for the product was 252.06, which was called the CRCIS Index, with a sensitivity of 86.0% and specificity of 79.8%.CONCLUSION Hypercoagulability induced by elevated CEA and neutrophils may be an important cause of CRCIS. The CRCIS index, which serves as a biomarker of CRCIS, needs further study.
基金The Foundation of Prevention and Control of Chronic Diseases in Central-South China(Guangxi),No.2018YFC1311305the Foundation of Science and Technology Plan Projects of Qingxiu District of Nanning,No.2020043.
文摘BACKGROUND The diagnosis of both cancer and intracerebral hemorrhage(ICH)in the same patient is not uncommon,but the clinical features and pathogenesis of patients with colorectal cancer(CRC)and ICH are still not well known.AIM To investigate the clinical features and underlying pathogenesis of ICH in patients with CRC.METHODS A retrospective review of CRC patients complicated with ICH from three centers between January 2014 and December 2020 was performed.Clinical data such as laboratory examinations,imaging features,prognosis,and underlying pathogenesis were analyzed.RESULTS Of 16673 identified CRC patients,20(0.12%)suffered from ICH.There were 13 males and 7 females,with an average age(mean±SD)of 68.45±10.66 years.Fourteen patients(70%)had distant metastases and most patients(85%)showed an elevation of one or more cancer biomarkers.The hemorrhagic lesions in 13 patients(65%)were in the intracerebral lobe.Four patients were completely dependent and 4 died within 30 days after hemorrhage.Intratumoral hemorrhage(50%)and coagulopathy(50%)accounted for the majority of hemorrhages.CONCLUSION Patients with ICH and CRC often have clinical features with lobar hemorrhage,distant metastases and poor prognosis.Intratumoral hemorrhage and coagulopathy are the main causes of ICH in patients with CRC.
