Cancer (Cr) and ischemic stroke (IS) are common causes of death in high-income regions. Cr patients present a higher probability of developing thromboembolic events, particularly IS. Measurable objective parameters may be helpful stating a neoplastic etiology: High D-dimer (DD) levels; C-reactive protein (CRP); Neutrophil–lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) express the severity of inflammation relating it to etiology and prognosis. Single centre retrospective study analyses patients with IS and active solid Cr (NG) with purpose of identifying clinical, laboratorial and imagological features that differentiate this from a control group (CG) without Cr.
Patients with IS admitted in a Stroke Unit from 01/2009 to 12/2014. Active cancer identified in clinical process. Transient ischemia, haemorrhagic strokes and other diagnosis excluded. For CG an age and gender matching patient was chosen. Clinical, analytical and imagological features were compared between groups. Statistical analysis using the SPSS Statistics V22.
Out of 603 consecutive patients with IS, 48 (7.9%) had active solid Cr, 16 diagnosed during diagnostic work-up for IS, 24 before and 8 in the year after. Male predominance: 30 patients (62,5%). 14: metastatic disease. Most frequent Cr diagnosed were prostate and bladder (12,5% each); colon(10%) and lung(8,3%). Cardioembolism was the main subgroup in both (26 NG; 24 CG). Imagiologic pattern was similar in both groups. NG had increased laboratorial values compared to CG: LDH 602 vs 501 U/L (p 0,04); CPR 3,2 vs 1,8 mg/dL (p 0,11) and DD 0,85 vs 0,7ug/mL (p 0,28). Average NLR and PLR: 5,4 and 161,6 NG vs 2,34 and 104,1 CG (p
Although Cr is a rare cause of stroke, it should not be devalued. There are several clinical, laboratory and imagiological signs of underlying neoplastic disease that should be considered, since they may promote an earlier diagnosis and approach to this pathology. Future prospective studies should be started in order to validate some of this parameters as indicators of subjacent neoplastic disease.
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All authors have declared no conflicts of interest.