Clinical Characteristics and Risk Factors of Lung Cancer-Associated Acute Ischemic Stroke

Abstract

Objective. To research the clinical characteristics and risk factors of lung cancer-associated acute ischemic stroke (LCA-AIS). Methods. Patients diagnosed with LCA-AIS, simple lung cancer, and simple AIS were enrolled. The primary information, laboratory results, tumor histopathology, neurological deficits, and survival time of the patients were collected and analyzed. Results. (1) In the LCA-AIS group, the pathology of 69.56% patients were adenocarcinoma, and the proportion of poorly differentiated patients was significantly more than that in moderately differentiated or highly differentiated. The number of stage IV lung cancer patients in the LCA-AIS group was significantly more common than in other stages. (2) 56.52% of patients with lung cancer were diagnosed before AIS, and the peak of AIS attack was 1–6 months after the diagnosis of lung cancer. (3) The independent risk factors of LCA-AIS were CYFRA-211 (OR 1.070; 95% confidence interval 1.005, 1.139; p=0.035), TT (OR 1.275; 95% confidence interval 1.089, 1.493; p=0.003), and Hct (OR 0.878; 95% confidence interval 0.779, 0.990; p=0.034), making ROC curve, suggesting the area under the curve is 0.871. (4) The neurological deficit of patients in the LCA-AIS group was similar to the simple AIS group and could not be identified by the severity of neurological deficits. (5) The median survival time of LCA-AIS group patients was five months (95% confidence interval 3.796, 6.204). There were statistical differences in survival time between LCA-AIS group and simple AIS group patients (p<0.001).Conclusions. The interaction between lung cancer and AIS may shorten patients’ life expectancy and worsen their quality of life.

Clinical practice: intravenous thrombolysis in a patient with active cancer who experienced wake-up stroke

“…The patient's laboratory results suggested D-dimer, thrombin time, CA125, CA19-9, and CYFRA21-1 were significantly abnormal, which were similar to the risk factors of lung cancer-associated AIS. 10,11 In terms of imaging findings, the AIS lesions involved bilateral cerebral hemispheres and anterior and posterior circulation, which meet the characteristics of cancer-associated AIS. 12 A randomized controlled study found that the initial symptoms of neurological deficits in patients with wake-up stroke were usually mild.…”

“…Our previous research suggested that the median survival time of patients with lung cancer-associated AIS was only 5 months. 10 However, we followed up with the patient for 10 months and AIS did not occur again.…”

Temporal trends and outcomes in acute ischaemic stroke patients with a current or historical diagnosis of cancer

“…It was also found that lung cancer had worse prognosis with highest rates of in-hospital mortality, cerebral edema, pneumonia, non-routine discharge and intracranial hemorrhage. One explanation for increased complications is that the interaction between lung cancer and AIS may shorten patients' life expectancy and worsen their quality of life [38]. Another retrospective study based on the SEER database also found that stroke mortality was significantly increased in patients with lung cancer compared with the general population (standardized mortality ratios 1.73, 95% CI 1.69-1.78) [39].…”

Transcriptomic analysis reveals the potential biological mechanism of AIS and lung adenocarcinoma

“…In patients with LUAD combined with AIS, LUAD occurs due to the occurrence of AIS. The prevalence of lung cancer in the stroke cohort was 5.3 per 1000 person-years ( 27 , 28 ). Lung cancer patients are most likely to experience a stroke within one year after diagnosis.…”