Lung cancer is associated with acute ongoing cerebral ischemia: A population-based study.

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY
International Journal of Stroke Pub Date : 2024-04-01 Epub Date: 2023-12-11 DOI:10.1177/17474930231217670
Jonathan Naftali, Rani Barnea, Ruth Eliahou, Keshet Pardo, Assaf Tolkovsky, Meital Adi, Vadim Hasminski, Walid Saliba, Sivan Bloch, Guy Raphaeli, Avi Leader, Eitan Auriel
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引用次数: 0

Abstract

Background and objectives: Cerebral microinfarcts (CMIs) are the most common type of brain ischemia; however, they are extremely rare in the general population. CMIs can be detected by magnetic resonance diffusion-weighted imaging (MRI-DWI) only for a very short period of approximately 2 weeks after their formation and are associated with an increased stroke risk and cognitive impairment. We aimed to examine CMI detection rate in patients with lung cancer (LC), which is strongly associated with ischemic stroke risk relative to other cancer types.

Methods: We used the Clalit Health Services record (representing more than 5 million patients) to identify adults with LC and breast, pancreatic, or colon cancer (non-lung cancer, NLC) who underwent brain magnetic resonance diffusion (MRI) scan within 5 years following cancer diagnosis. All brain MRI scans were reviewed, and CMIs were documented, as well as cardiovascular risk factors.

Results: Our cohort contained a total of 2056 MRI scans of LC patients and 1598 of NLC patients. A total of 143 CMI were found in 73/2056 (3.5%) MRI scans of LC group compared to a total of 29 CMI in 22/1598 (1.4%) MRI scans of NLC (p < 0.01). Cancer type (e.g. LC vs NLC) was the only associated factor with CMI incidence on multivariate analysis. After calculating accumulated risk, we found an incidence of 2.5 CMI per year in LC patients and 0.5 in NLC.

Discussion: CMIs are common findings in cancer patients, especially in LC patients and therefore might serve as a marker for occult brain ischemia, cognitive decline, and cancer-related stroke (CRS) risk.

肺癌与急性持续性脑缺血有关。
背景和目的:脑微梗死(CMI)是最常见的脑缺血类型,但在普通人群中极为罕见。磁共振弥散加权成像(MRI-DWI)只能在形成后大约2周的很短时间内检测到CMI,并且与卒中风险增加和认知障碍有关。我们的目的是研究肺癌(LC)患者的CMI检出率,相对于其他癌症类型,LC与缺血性卒中风险密切相关。方法:我们使用Clalit健康服务记录(代表超过500万患者)来识别患有LC,乳腺癌,胰腺癌或结肠癌(非肺癌,NLC)的成年人,他们在癌症诊断后5年内进行了脑部MRI扫描。所有的脑部MRI扫描都被复查,CMI和心血管危险因素都被记录下来。方法:我们的队列共包含2056例LC患者和1598例NLC患者的MRI扫描。LC组73/2056次MRI扫描共发现143个CMI(3.5%),而NLC组22/1598次MRI扫描共发现29个CMI(1.4%)。(pDiscussion: CMI是癌症患者常见的发现,尤其是LC患者,因此可能作为隐匿性脑缺血、认知能力下降和CRS风险的标志。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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