The clinical features and possible pathogenesis of acute ischemic stroke in renal cell cancer patients / 中国医师进修杂志

ABSTRACT

Objective To study the clinical features and possible pathogenesis of acute ischemic stroke in renal cell cancer patients. Methods The clinical data from in-hospital patients with renal cell cancer who developed acute ischemic stroke were collected, including the patients with renal cell cancer who developed acute ischemic stroke during anti-cancer therapies and those patients with acute ischemic stroke who were firstly diagnosed to have renal cell cancer during anti-stroke therapies between January 2003 and December 2015. Results A total of 2516 patients with renal cell cancer were screened, and there were 36 patients (1.43%) with acute ischemic stroke. Out of the 36 patients, there were 29 men (80.56%) and 7 women (19.44%). Their age ranged from 45 to 68 years, with a average age of (65.11 ± 14.77) years. Eight patients (22.22%) had some conventional cardiovascular risk factors, while the other 28 patients (77.78%) had no such risk factors. Magnetic resonance imaging (MRI) scans at the acute stage of ischemic stroke were carried out for all these patients. Based on the diffusion weighted imaging (DWI) of MRI, 8 patients (22.22%) had single lesion and 28 patients (77.78%) had multiple lesions in different arterial territories in their brains. The pathological types of renal cell cancer weresuprarenal epithelioma (18 patients, 50.00%), papillary cell carcinoma (12 patients, 33.33%) and chromophobe renal cell carcinoma (6 patients, 16.67%). Metastases were found 10 patients (27.78%) out of the 36 patients. Blood biochemical examination showed that 28 patients had elevated plasma D-dimer level, 22 patients had elevated plasma cancer antigen (CA)125 level, and 17 patients had elevated plasma carcinoembryonic antigen (CEA) levels. Conclusions It is suggested that the renal cell cancer associated stroke is characterized by lacking of traditional risk factors and having multiple lesions in brain;and that the elevated plasma D-dimer, CA125 and CEA levels may lead to hypercoagulable state and lead to ischemic stroke eventually .