【ISC2015】卒中幸存者发生癌症的风险可能较高

纳什维尔——2015国际卒中大会（ISC2015）上的一项研究显示，发生过卒中的患者出现癌症的风险可能比未发生过卒中的个体要高。

明尼苏达州圣·克劳德市仁娜特库雷西卒中研究院研究小组的Malik Adil（M.D.）是这项研究领衔作者，他说：“我们已经知道癌症患者发生卒中的风险较高。但是反过来卒中幸存者发生癌症的风险是不是也是如此？这就是我们的问题。”

研究组分析了维生素干预预防卒中（VISP）多中心试验中1997年至2001年的数据。这项研究共包括3,247没有癌症的受试者，受试者年龄均在35岁以上，并发生过轻度缺血性（血块导致）卒中。

研究发现：

·卒中患者与一般人群相比，校正年龄后的癌症年发病率较高。

·卒中发生后1年时，幸存者中癌症风险是一般人群的1.2倍；2年时是后者的1.4倍。

·发生癌症卒中幸存者的死亡风险是未发生癌症幸存者的3倍。

Adil说，患有癌症与缺血性卒中风险较高相关主要是由于癌症患者的血液更加容易凝结。“此外，组织氧供因血管阻塞减少时，组织细胞因之凋亡并引发一系列事件改变正常的生理活动，并可能导致癌症。”

另一个癌症风险因素是年龄。研究显示，年龄大于50岁的卒中幸存者2年内发生癌症的风险是50岁或更年轻幸存者的1.4倍。

研究者应用美国国家癌症研究所的数据确定一般人群中的癌症风险，并计算得出了卒中幸存者在卒中后1个月、6个月、1年和2年时与未发生过卒中群体的癌症风险的差异。

他们还计算并比较了发生癌症的卒中幸存者与未发生癌症的幸存者的死亡和其他心血管事件的风险。

受试者发生的癌症种类多样，包括皮肤癌、前列腺癌、乳腺癌、肺癌和膀胱癌。

Adil说：“如果你曾经出现过卒中，尤其还存在另一种高风险因素，那么与医生讨论早期癌症筛查很重要。发生癌症的高风险因素包括吸烟、饮酒和有癌症家族史。”

共同作者包括美国心脏病学会院士Adnan Qureshi（M.D.）、Ahmed Malik（M.D.）、Omar Saeed（M.D.）和Fareed Suri（M.D.）。作者声明见摘要。

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NASHVILLE, Tenn., Feb. 12, 2015 – People who had a stroke may develop cancer at a higher rate than those who do not have a stroke, according to research presented at the American Stroke Association’s International Stroke Conference 2015.

 “We already knew that cancer patients are at increased risk of stroke. But what happens when you turn it around and look at cancer risks for ischemic stroke survivors? That was our question,” said Malik Adil, M.D., lead author from the research team at the Zeenat Qureshi Stroke Institute in St Cloud, Minnesota.

The team analyzed data from the Vitamin Intervention for Stroke Prevention (VISP) multicenter trial from 1997 to 2001. The analysis consisted of 3,247 cancer-free participants over the age of 35 who had a mild ischemic (clot-caused) stroke. 

Researchers found:

The annual rate of age-adjusted cancer incidence was higher among ischemic stroke patients compared with the general population.

The rate of cancer occurring among stroke survivors was 1.2 times higher at one year, and 1.4 times higher at two years.

Stroke survivors who developed cancer had up to three-times higher chance of dying compared to those who didn’t get cancer.

Having cancer is linked to higher ischemic stroke risks mainly because cancer patients’ blood tends to clot more often, Adil said. “In addition, when tissues get less oxygen due to blocked blood vessels, it destroys tissue cells and sets off a series of events to alter the normal physiology and may lead to cancer.”

Another risk factor for developing cancer was age. The study showed stroke survivors over age 50 were 1.4 times more likely to develop cancer within two years than their counterparts who were age 50 and under.

The researchers used National Cancer Institute data for the general population’s cancer rates. Then they calculated cancer rate differences between the stroke and non-stroke groups at one month, six months, one year and two years.

They also calculated the risk of death and other cardiovascular events, and compared those findings between stroke survivors who did and didn’t develop cancer.

Participants developed a wide range of cancers, including skin, prostate, breast, lung and bladder cancer.

“If you’ve had a stroke before, especially with another high-risk factor, it’s important that you talk to your doctor and discuss earlier cancer screening,” said Adil.  “Factors that may put a person at higher risk for developing cancer include: cigarette smoking, alcohol consumption and a family history of cancer.

Co-authors are Adnan Qureshi, M.D., FAHA; Ahmed Malik, M.D.; Omar Saeed, M.D., and Fareed Suri, M.D. Author disclosures are on the abstract.

Copyright © 2015 Elsevier Inc. All rights reserved.