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2015年国际卒中大会上公布的一项研究显示，卒中患者罹患癌症风险高于没有卒中的患者。
Malik Adil博士（明尼苏达州圣科鲁Zeenat Qureshi卒中研究所）介绍，我们已经知道癌症患者的卒中发病风险增加，但是缺血性卒中患者的癌症发病风险会增加吗？我们对这一问题进行了探讨。
研究者从
研究发现：
• 年龄调整的癌症年发生率：缺血性卒中患者高于普通人群
• 卒中幸存者癌症年一年发生率是对照组的1.2倍，两年发生率是对照组的1.4倍
• 卒中后罹患癌症的患者死亡率是未罹患癌症卒中患者的3倍。
Adil解释，癌症患者缺血性卒中风险发生更高的原因是癌症导致其血液更容易形成血栓。而卒中患者因血管阻塞导致缺氧、组织破坏，并引发一系列的事件改变正常的生理功能，可能导致癌症。癌症的另一个危险因素是年龄。研究显示，50岁以上的卒中患者与50岁及以下的卒中患者相比，两年内罹患癌症的风险高1.4倍。
Adil认为，对于卒中患者，特别是还有其他高危因素（吸烟、饮酒和癌症家族史等），医生应该和患者讨论早期癌症筛查的问题。
点击进入>>>2015国际卒中大会(ISC)专题报道
医脉通编译自：Stroke survivors may be at higher risk of having cancer. ISC newsroom. February 12, 2015
研究摘要：The Risk of a Diagnosis of Cancer after Ischemic Stroke: Two Year Follow-up Study of 3247 Cancer Free Ischemic Stroke Patients
Background: Subclinical cancer can manifest as a thrombo-embolic event and may be detected at a later interval in ischemic stroke survivors.
Objective: To determine the rate of incident cancer and effect on cardiovascular endpoints in a large cohort of ischemic stroke survivors.
Methods: An analysis of 3680 adults with non-disabling cerebral infarction who were followed for two years within the randomized, double-blinded VISP trial was performed. We calculated age adjusted rates of incidence of cancer among ischemic stroke survivors and calculated the standardized incidence ratios (SIR) with 95% confidence intervals (CI) based on comparison with age-adjusted rates in the general population. A logistic regression analysis evaluated the association between incident cancer and various endpoints including stroke, coronary heart disease, myocardial infarction, and death after adjusting age, gender, and race/ethnicity.
Results: A total of 3247 patients (mean age (±SD) of 66 (±11); 2013 were men) were cancer free at the time of enrollment. The incidence of new cancer was 0.15, 0.80, 1.2, and 2.0 per 100 patients at 1 month, 6 month, 1 year, and 2 years, respectively. The age adjusted annual rate of cancer in patients with ischemic stroke over 1 year after recruitment was 581.8/100,000 persons which was higher than the age adjusted cancer rate of 486.5/100,000 persons in the general population (SIR 1.2, 95% CI 1.16-1.24). The age adjusted annual rate continued to be higher in patients with ischemic stroke over 2 years after recruitment (1301.7/100,000 versus 911.5/100,000, SIR 1.4, 95% CI 1.2-1.6). There was a higher risk for death (OR 3.1, 95% CI, 1.8-5.4), fatal/disabling stroke or death (OR 2.3, 95% CI 1.4-3.7), and composite endpoint of stroke, coronary heart disease, and/or death (OR 1.4, 95% CI 1.0-2.2) among participants who developed incident cancer compared with those who were cancer free after adjusting for potential confounders.
Conclusions: The annual rate of age adjusted cancer incidence was higher among ischemic stroke patients compared with general population. The risk of mortality was three folds greater among stroke survivors who developed incident cancer.
Author：Adnan I Qureshi, Ahmed A Malik, Omar Saeed, Malik M Adil, Fareed K Suri, Zeenat Qureshi Stroke Inst, St. Cloud, MN
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