Clinical characteristics and tumor markers in ischemic stroke patients with active cancer

AbstractCancer-associated ischemic stroke (CAS) refers to a hypercoagulation disorder related to malignant tumors, especially adenocarcinoma. Carbohydrate antigen (CA) 125 is a mucinous serum marker that might reflect hypercoagulation status, but the association between CA 125 and CAS is unclear across various types of cancer. The aim of this study was to investigate the associations among tumor markers, coagulation markers, and clinical factors in acute ischemic stroke (AIS) patients with active cancer. Consecutive AIS patients with active cancer (a diagnosis or ongoing active therapy for cancer within 6  months) were prospectively enrolled at four hospitals. D-dimer, C-reactive protein (CRP), carcinoembryonic antigen (CEA), CA19-9, and CA 125 levels were measured. Of 120 AIS patients with active cancer, 47 were diagnosed with CAS. CA 125 had the strongest correlations with D-dimer and CRP (ρ = 0.543,p <  0.001 andρ = 0.452,p <  0.001, respectively). The areas under the receiver-operating characteristic curves for the diagnosis of CAS were 0.812 (95% CI 0.718–0.878) for CA 125, 0.714 (95% CI 0.602–0.801) for CEA, and 0.663 (95% CI 0.552–0.759) for CA 19-9. Multivariable analysis revealed that CA 125 levels in the h ighest quartile (OR 2.91, 95% CI 1.68–5.53), multiple lesions in multiple vascular territories observed on diffusion-weighted imaging, the absence of dyslipidemia, and the absence of atrial fibrillation were independently associate...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research