The Clinical Feature And Potential Pathogenesis Of Lung Cancer Patients With Acurte Ischemic Stroke

Objective The aim of this study is to investigate the clinical feature ofcerebral infarction in patients with lung caner，as well as its underlyingpathogenesis.Methods A retrospective review of all ischemic stroke patients with lungcancer (n=102) admitted to The First Affiliated Hospital of Guangxi MedicalUniversity from January2003to December2012was recruited as theexperimental group(Lung Cancer and Stroke Group，LCG).At the same time，recruit the patients with active lung cancer without stroke as the comparisongroup1(Lung Cancer Group，LG)，and patients with a new ischemic strokewithout cancer as the comparison group2(Stroke Group，SG).These patientswere age and gender-matched between groups.Collect and compare the clinicaldata between groups.Results The average age was（52.92±10.37）years in the patients ofLSG，84were male，18were female. No significant difference between thegroups in the average age and sex distribution. Among the patients of LSG，23patients experienced cerebral infarction as the first performance of lung cancer，58patients occurred ischemic stroke within four months after the diagnosed of lung cancer. Compared to SG patients， there are more patients withoutconventional risk factor (CRF) for stroke among LSG，more patients werecryptogenic strokes and brain imaging showed involvement of multipleintracranial artery lesions in multiple encephalic regions，the level of D-dimersignificantly increased，the prognosis was worse. Compared with LG patients，LSG patients had a higher incidence of metastasis，the level of D-dimer、cancerantigen （CA）125、CA199was higher. Multiple logistic regression analysisshowed that the risk of cerebral infarction in lung cancer patients increased byabout0.2%, while D-dimer increased by1ug/mL (OR,1.002;95%CI,1.000-1.004; P=0.017)；the risk of cerebral infarction in lung cancer patientsincreased by about0.6%, while CA125increased by1U/mL (OR,1.006;95%CI,1.001-1.010; P=0.017); the risk of cerebral infarction in lung cancer patientsincreased by about2.1%, while CA199increased by1U/mL (OR,1.011;95%CI,1.011-1.024; P=0.000).Conclusion After the diagnosis of lung cancer，more ischemic strokeoccured within the first four months. More patients lack of conventional riskfactor for stroke， stroke agent was unclear and brain imaging showedinvolvement of multiple intracranial artery lesions in multiple encephalicregions were the clinical features of ischemic stroke with lung cancer. Theoccurrence of stroke among lung cancer patients may be associated withhypercoagulability caused by cancer cell.