Specific Biomarkers of Prostate Cancer-Associated Ischemic Stroke: A Case-Control Study

Chen, Ya; Qin, Qixiong; Qin, Chao; Cheng, Daobin; Wei, Yunfei; Liang, Zhijian

doi:10.12659/msm.917970

Cited by 2 publications

(17 citation statements)

References 33 publications

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“…A few studies have reported associations between NLR and cancer-associated stroke incidence. Chen et al 22 reported that elevated D-dimer, total prostate-specific antigen and NLR were independent risk factors of ischaemic stroke among patients with prostate cancer, though this study did not adjust for cancer stage. In contrast, we used data on cancer stage, cancer site, and duration from diagnosis to ischaemic stroke, and applied survival tree analysis and multivariate Cox hazard regression models.…”

Section: Discussionmentioning

confidence: 84%

High neutrophil/lymphocyte ratio at cancer diagnosis predicts incidence of stroke in cancer patients

Kawano

Sasaki

Gon

et al. 2021

Brain Communications

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Although cancer increases the incidence and severity of ischemic stroke, there is no reliable method for predicting ischemic stroke in cancer patients. To evaluate the prognostic capacity of the neutrophil-to-lymphocyte ratio at cancer diagnosis for predicting the incidence of ischemic stroke, we used a hospital-based cancer registry that contained clinical data from all patients treated for cancer at Osaka University Hospital between 2007 and 2015. The neutrophil-to-lymphocyte ratio was calculated after dividing absolute neutrophil counts by absolute lymphocyte counts. These counts were obtained within 1 month after cancer diagnosis. The primary endpoint was new-onset ischemic stroke within 2 years after cancer diagnosis. Of the 18,217 included cancer patients (median age: 65.2 years), 69 (0.38%) had ischemic stroke. Unadjusted Cox regression analysis stratified by cancer site demonstrated that each 1-unit increase in the neutrophil-to-lymphocyte ratio was associated with a significant 7.2% increase in the risk of an ischemic stroke event (95% confidence interval 1.041–1.103, P<0.001). Survival tree analysis and the Kaplan–Meier method suggested that patients with and without atrial fibrillation who had increased neutrophil-to-lymphocyte ratios had a higher risk of ischemic stroke. Multivariate Cox proportional hazard models, adjusted for cancer site and stage, revealed that patients with high neutrophil-to-lymphocyte ratios (>15) had higher ischemic stroke risk than patients with low neutrophil-to-lymphocyte ratios (<5). This was true among cancer patients both with (hazard ratio 11.598; 95% confidence interval 0.953–141.181) and without (hazard ratio 7.877; 95% confidence interval 2.351–26.389) atrial fibrillation. The neutrophil-to-lymphocyte ratio at cancer diagnosis is associated with the incidence of ischemic stroke among cancer patients and might thus be useful for identifying patients at high risk of ischemic stroke, allowing us to guide future preventive interventions. Kawano et al. report that the elevated neutrophil-to-lymphocyte ratio at cancer diagnosis is associated with the incidence of ischemic stroke within 2 years after cancer diagnosis, suggesting that neutrophil-to-lymphocyte ratio at cancer diagnosis might be useful for identifying patients at high risk of ischemic stroke.

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Section: Discussionmentioning

confidence: 84%

High neutrophil/lymphocyte ratio at cancer diagnosis predicts incidence of stroke in cancer patients

Kawano

Sasaki

Gon

et al. 2021

Brain Communications

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“…34 52 61 75 80 120 Chen et al studied mean platelet count as a predictor for ischemic stroke in a group of prostate cancer patients without traditional risk factors for stroke. 34 Li et al and Shi et al investigated postoperative VTE in cervical cancer and glioma patients, 52 75 respectively, while Sutandyo et al investigated chemotherapy-related VTE 120 and von Tempelhoff et al investigated patients undergoing both surgery and chemotherapy. 80 Monreal et al studied catheter-related deep venous thrombosis (DVT).…”

Section: Resultsmentioning

confidence: 99%

“…Among the identified 26 studies on mean and median platelet count and association with thrombosis, mean platelet count and standard deviation could be retrieved for meta-analysis in 14 studies. 27 29 34 36 52 61 69 75 80 82 85 108 112 120 Thirteen of these studies rated good or fair, 29 34 36 52 61 69 75 80 82 85 108 112 120 while one study rated poor. 27 A substantial between-study heterogeneity was observed in 14 studies (Q = 166.32 on 13 df; p = 0.00; I 2 = 93.44%, p = 0.00), explaining why a pooled SMD was estimated using a random-effects model.…”

Section: Resultsmentioning

confidence: 99%

“…In this review, four studies with ATE as outcome were included, 34,62,69,109 of which three investigated ischemic stroke. 34,62,69 One study on ischemic stroke found a significant association with higher platelet count, 69 and two studies found no association. 34,62 Furthermore, in most studies including both VTE and ATE, ATEs made up a small proportion of the total events, making results difficult to interpret.…”

Section: Discussionmentioning

confidence: 99%

“…27 Six studies rating fair reported no significant difference in mean platelet count between cancer patients who developed thrombosis and those who did not develop thrombosis. 34,52,61,75,80,120 Chen et al studied mean platelet count as a predictor for ischemic stroke in a group of prostate cancer patients without traditional risk factors for stroke. 34 Three studies investigating median platelet count found an association between higher median platelet count and thrombosis.…”

Section: Platelet Count and Thrombosismentioning

confidence: 99%

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Platelet Parameters as Biomarkers for Thrombosis Risk in Cancer: A Systematic Review and Meta-analysis

Malte

Højbjerg

Larsen

2023

Semin Thromb Hemost

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Cancer-associated thrombosis (CAT) is a major cause of both morbidity and mortality in cancer patients. Platelet count has been investigated as a predictor of CAT in various settings while knowledge on platelet activation parameters is sparse. This report provides a systematic review and meta-analysis on available literature on associations between platelet count and/or function and arterial and venous thrombosis in adult cancer patients. The review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. PubMed and Embase were searched up to March 2022. The National Heart, Lung, and Blood Institute's tools were used for quality assessment. In total, 100 studies were included which investigated the association between CAT and platelet count (n = 90), platelet indices (n = 19), and platelet function/activation markers (n = 13) in patients with solid cancers (n = 61), hematological cancers (n = 17), or mixed cancer types (n = 22). Eighty-one studies had venous thrombosis as their outcome measure, while 4 had arterial thrombosis and 15 studies had both. We found significantly elevated odds ratio of 1.50 (95% confidence interval: 1.19–1.88) for thrombosis with higher platelet counts. We saw a tendency toward an association between markers of platelet activation in forms of mean platelet volume and soluble P selectin and both arterial and venous thrombosis. Only one study investigated dynamic platelet function using flow cytometry. In conclusion, platelet count is associated with CAT across different cancer types and settings. Platelet function or activation marker analysis may be valuable in assisting thrombosis risk assessment in cancer patients but is sparsely investigated so far.

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Specific Biomarkers of Prostate Cancer-Associated Ischemic Stroke: A Case-Control Study

Cited by 2 publications

References 33 publications

High neutrophil/lymphocyte ratio at cancer diagnosis predicts incidence of stroke in cancer patients

High neutrophil/lymphocyte ratio at cancer diagnosis predicts incidence of stroke in cancer patients

Platelet Parameters as Biomarkers for Thrombosis Risk in Cancer: A Systematic Review and Meta-analysis

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