19702名日本缺血性卒中患者的癌症亚型、风险概况和死亡率的性别差异：来自日本生物银行的队列研究

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-09-09 DOI:10.1016/j.jstrokecerebrovasdis.2025.108449

Takashi Shimoyama MD, PhD , Yoichiro Kamatani MD, PhD , Koichi Matsuda MD, PhD , Hiroki Yamaguchi MD, PhD , Kazumi Kimura MD, PhD

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引用次数: 0

摘要

背景：关于缺血性脑卒中患者癌症亚型、风险概况和死亡率的性别特异性差异的数据有限。方法：本研究分析了在BioBank Japan数据库中登记的19,702例缺血性卒中患者（n=12,241名男性；n=7,261名女性）。我们比较了男性和女性在14个常见解剖部位和性别特异性癌症患病率的调整优势比（aOR）和95%置信区间（CI）。采用多变量logistic回归模型，按性别估算与癌症史相关的传统卒中危险因素的aORs和95% ci。Cox比例风险回归用于估计基于性别癌症病史的死亡率的校正风险比（aHR）和95% ci。结果：19702人中有1656人（8.4%）有癌症病史。男性胃癌（aOR为1.74[1.26-2.41]）、膀胱癌（aOR为3.49[1.73-3.03]）、肾癌（aOR为4.74[1.84-12.25]）、咽喉癌（aOR为6.65[2.17-20.39]）的发病率明显高于女性。相反，性别特异性癌症（aOR为0.66[0.52-0.84]）在男性中的发病率明显低于女性。在男性中，年龄较大（aOR 1.80[1.67-1.94]）、慢性肾脏疾病（aOR 1.73[1.23-2.44]）、房颤（aOR 1.38[1.07-1.77]）、吸烟（aOR 1.27[1.09-1.47]）和既往卒中（aOR 1.16[1.02-1.32]）与癌症史独立相关。在女性中，年龄较大（aOR为1.15[1.05-1.25]）是与癌症病史相关的唯一独立因素。在中位随访10年期间，癌症病史增加了男性（aHR 1.27[1.16-1.39]）和女性（aHR 1.32[1.14-1.48]）的全因死亡风险。结论：缺血性脑卒中患者在癌症亚型和风险谱上存在性别特异性差异。

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Sex differences in subtypes, risk profiles, and mortality for cancer among 19,702 Japanese patients with ischemic stroke: A cohort from BioBank Japan

Background

Limited data exists on sex-specific differences in cancer subtypes, risk profiles, and mortality among patients with ischemic stroke.

Methods

This study analyzed 19,702 ischemic stroke patients (n = 12,241 men; n = 7,261 women) registered in the BioBank Japan database. We compared adjusted odds ratios (aOR) and 95 % confidence intervals (CI) for the prevalence of cancer across 14 common anatomical sites and sex-specific cancers between men and women. A multivariate logistic regression model was used to estimate aORs and 95 %CIs for traditional stroke risk factors associated with a cancer history by sex. Cox proportional hazards regression was used to estimate adjusted hazard ratios (aHR) and 95 %CIs for mortality based on cancer history by sex.

Results

Among the 19,702 individuals, 1,656 (8.4 %) had a history of cancer. Men showed significantly higher incidences of gastric (aOR 1.74[1.26-2.41]), bladder (aOR 3.49[1.73-3.03]), kidney (aOR 4.74[1.84-12.25]), and pharyngeal/laryngeal (aOR 6.65[2.17-20.39]) cancers compared to women. Conversely, sex-specific cancers (aOR 0.66[0.52-0.84]) were significantly less common in men than in women. In men, older age (aOR 1.80[1.67-1.94]), chronic kidney disease (aOR 1.73[1.23-2.44]), atrial fibrillation (aOR 1.38[1.07-1.77]), smoking (aOR 1.27[1.09-1.47]), and prior stroke (aOR 1.16[1.02-1.32]) were independently associated with a history of cancer. In women, older age (aOR 1.15[1.05-1.25]) was the only independent factor associated with a cancer history. During a median follow-up of 10 years, a history of cancer increased all-cause mortality risk in both men (aHR 1.27[1.16-1.39]) and women (aHR 1.32[1.14-1.48]).

Conclusion

Sex-specific differences in cancer subtypes and risk profiles were present among patients with ischemic stroke.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.