A clinical research on the potential pathogenesis of somatic cancer related cerebral venous sinus thrombosis

Xian, Ziqiang; Chen, Zhong; Chen, Li; Lu, Qiuhong; Huang, Guifeng; Qin, Qixiong; Liang, Zhijian

doi:10.1097/md.0000000000015134

Cited by 10 publications

(15 citation statements)

References 33 publications

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“…No previous studies have reported a relationship between lymph node metastasis in tongue cancer and the PNR. Xian et al 19 studied 174 patients with solid carcinoma‐related cerebral venous sinus thrombosis and found that the higher PNR, the higher the probability of intracranial metastasis in these patients. This finding is similar to our finding that when PNR was >60.889, OTSCC patients were more prone to early‐stage lymph node metastasis, their innate immunity was weakened, their neutrophil count was decreased, and their PLT count was unchanged, resulting in an elevated PNR.…”

Section: Discussionmentioning

confidence: 99%

Prediction of lymph node metastasis in oral tongue squamous cell carcinoma using the neutrophil‐to‐lymphocyte ratio and platelet‐to‐neutrophil ratio

Wang

Liu

Zhong

2021

Clinical Laboratory Analysis

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Background Lymph node metastasis in a variety of tumors is associated with systemic inflammatory markers. However, this association has not been reported in oral tongue squamous cell carcinoma (OTSCC). This study aimed to investigate how the preoperative neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐neutrophil ratio (PNR) in OTSCC patients correlated with the occurrence of OTSCC and lymph node metastasis. Methods The data of 73 patients with primary OTSCC who underwent surgical resection were retrospectively analyzed. Patients with other malignant tumors, patients who had received radiotherapy or chemotherapy before surgery, and patients with active inflammation were excluded. The enrolled patients were divided into groups N0 (no early‐stage lymph node metastasis) and N1 (early‐stage lymph node metastasis). Venous blood samples were collected before surgery and at the third week after surgery and subjected to complete blood counting in a blood analyzer. Eighty‐seven healthy people were included as a control group. In addition, the NLR and PNR in OTSCC patients were compared with those in the controls, and the postoperative NLR and PNR of group N0 were compared with those of group N1. Results The NLR was significantly higher in the OTSCC patients than the controls (p < 0.05). The area under the receiver operating characteristic curve was 0.595. Further comparison of the NLR and PLR between group N0 and group N1 showed that when NLR was ≤1.622, and the probability of early‐stage lymph node metastasis in OTSCC patients was 73.3%, and when PNR was >60.889, the probability was 86.7%. In re‐examination 3 weeks postoperatively, the NLR and PNR were not significantly different between groups. Conclusion The NLR has certain reference value for the diagnosis of OTSCC. The preoperative NLR and PNR can be used to predict early‐stage lymph node metastasis in patients with histopathologically confirmed OTSCC.

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Section: Discussionmentioning

confidence: 99%

Prediction of lymph node metastasis in oral tongue squamous cell carcinoma using the neutrophil‐to‐lymphocyte ratio and platelet‐to‐neutrophil ratio

Wang

Liu

Zhong

2021

Clinical Laboratory Analysis

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“…The risk for CVST in the somatic cancer-related CVST group increased independently by 0.7% (odds ration [OR] 1.007; 95% confidence interval [CI] 1.000, 1.015; P = 0.047) with a 1 ng/ml increase in D-dimer levels and by 4.6% (OR 1.046; 95% CI 1.011, 1.083; P = 0.010) with a 1U/ml increased in carcinoembryonic antigen. 42 In the current case, the patient's D-dimer and CA125 levels were high. Therefore, for cancer patients, it is essential that coagulation indices are measured to prevent the occurrence of CVST.…”

Section: Discussionmentioning

confidence: 56%

Embryonic cervical rhabdomyosarcoma complicated with uterine inversion with cerebral venous sinus thrombosis as the first symptom: a case report and literature review

Zhang

Han

et al. 2021

J Int Med Res

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The probability of rhabdomyosarcoma occurring in the cervix is less than 0.5% and may be associated with a pathogenic dicer 1, ribonuclease III ( DICER1) gene variation. Tumour-induced hypercoagulability and high levels of cancer antigen (CA) 125 are risk factors for cerebral venous sinus thrombosis (CVST). In addition, although nonpuerperal uterine inversion is very rare and is usually caused by leiomyomas from the uterus, large cervical masses can also be the cause. This case report describes a 24-year-old woman with uterine inversion caused by an embryonic cervical rhabdomyosarcoma that presented with CVST as her first symptom. The patient underwent laparoscopic total uterus and bilateral salpingectomy, during which the uterus was found to be completely inverted. Postoperative pathology confirmed embryonic cervical rhabdomyosarcoma. The patient quickly developed lung and para-aortic lymph node metastases. Two months later, the patient died of complications. When coagulation indices in patients with tumours are abnormal, especially when the levels of D-dimer and CA125 increase, it is recommended that anticoagulant therapy is administered in a timely manner to prevent the occurrence of CVST. Furthermore, for large cervical tumours, physicians should also be alert to the occurrence of uterine inversion.

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“…But new-onset recurring headaches need a high index of suspicion for treatable conditions like CVST as we can improve outcomes in such patients. Our patient had a previous history of cancer, and about 7-10% of patients diagnosed with CVST have cancer (65). Even though it is unlikely that his treated cancer which is in remission caused CVST, it is important to note that cancer increases the risk of thrombosis (66).…”

Section: Discussionmentioning

confidence: 86%

Case Report: Cerebral Venous Sinus Thrombosis and COVID-19 Infection

et al. 2021

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Coronavirus disease-2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus). Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020 and has changed our lives in many ways. This infection induces a hypercoagulable state leading to arterial and venous thrombosis, but the exact pathophysiology of thrombosis is unknown. However, various theories have been postulated including excessive cytokine release, endothelial activation, and disseminated intravascular coagulation (DIC). We present a patient diagnosed with cerebral venous sinus thrombosis (CVST) with COVID-19 infection. A 66-year-old man presented to a hospital for evaluation of persistent headaches. He tested positive for COVID-19, and MRI of the brain and CT venogram revealed CVST. He was started on heparin drip in the hospital and transitioned to oral anticoagulants at the time of discharge. His headaches improved with treatment. Even though headache is the most frequent and initial symptom of cerebral venous thrombosis, it is rarely the only symptom. A high index of suspicion is therefore required to diagnose CVST especially if the patient presents with a simple complaint like a headache. Common complaints can delay the diagnosis leading to disease progression. Considering the high mortality rates in patients diagnosed with CVST, we suggest the importance of knowing the association between COVID-19 infection and CVST, especially in susceptible patients.

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A clinical research on the potential pathogenesis of somatic cancer related cerebral venous sinus thrombosis

Cited by 10 publications

References 33 publications

Prediction of lymph node metastasis in oral tongue squamous cell carcinoma using the neutrophil‐to‐lymphocyte ratio and platelet‐to‐neutrophil ratio

Prediction of lymph node metastasis in oral tongue squamous cell carcinoma using the neutrophil‐to‐lymphocyte ratio and platelet‐to‐neutrophil ratio

Embryonic cervical rhabdomyosarcoma complicated with uterine inversion with cerebral venous sinus thrombosis as the first symptom: a case report and literature review

Case Report: Cerebral Venous Sinus Thrombosis and COVID-19 Infection

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