Clues to occult cancer in patients with ischemic stroke.
BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with c...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2012-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3440364?pdf=render |
| _version_ | 1818504191798149120 |
|---|---|
| author | Suk Jae Kim Jae Hyun Park Mi-Ji Lee Yun Gyoung Park Myung-Ju Ahn Oh Young Bang |
| author_facet | Suk Jae Kim Jae Hyun Park Mi-Ji Lee Yun Gyoung Park Myung-Ju Ahn Oh Young Bang |
| author_sort | Suk Jae Kim |
| collection | DOAJ |
| description | BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke) group and without active cancer (CR-stroke) group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control). Clinical factors, lesion patterns on diffusion-weighted MRI (DWI), and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4%) patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001). Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001). D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001) and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001) were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke. |
| first_indexed | 2024-12-10T21:33:53Z |
| format | Article |
| id | doaj.art-06ecd9ba6054476d95d3dab62330726e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T21:33:53Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-06ecd9ba6054476d95d3dab62330726e2022-12-22T01:32:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4495910.1371/journal.pone.0044959Clues to occult cancer in patients with ischemic stroke.Suk Jae KimJae Hyun ParkMi-Ji LeeYun Gyoung ParkMyung-Ju AhnOh Young BangBACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke) group and without active cancer (CR-stroke) group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control). Clinical factors, lesion patterns on diffusion-weighted MRI (DWI), and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4%) patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001). Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001). D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001) and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001) were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.http://europepmc.org/articles/PMC3440364?pdf=render |
| spellingShingle | Suk Jae Kim Jae Hyun Park Mi-Ji Lee Yun Gyoung Park Myung-Ju Ahn Oh Young Bang Clues to occult cancer in patients with ischemic stroke. PLoS ONE |
| title | Clues to occult cancer in patients with ischemic stroke. |
| title_full | Clues to occult cancer in patients with ischemic stroke. |
| title_fullStr | Clues to occult cancer in patients with ischemic stroke. |
| title_full_unstemmed | Clues to occult cancer in patients with ischemic stroke. |
| title_short | Clues to occult cancer in patients with ischemic stroke. |
| title_sort | clues to occult cancer in patients with ischemic stroke |
| url | http://europepmc.org/articles/PMC3440364?pdf=render |
| work_keys_str_mv | AT sukjaekim cluestooccultcancerinpatientswithischemicstroke AT jaehyunpark cluestooccultcancerinpatientswithischemicstroke AT mijilee cluestooccultcancerinpatientswithischemicstroke AT yungyoungpark cluestooccultcancerinpatientswithischemicstroke AT myungjuahn cluestooccultcancerinpatientswithischemicstroke AT ohyoungbang cluestooccultcancerinpatientswithischemicstroke |