Biological markers of cancer-associated stroke

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K17907
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Laboratory medicine; Neurosurgery
• Research Institution: Hiroshima University
• Principal Investigator: Nezu Tomohisa 広島大学, 医系科学研究科(医), 助教 (10457260)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 悪性腫瘍関連脳梗塞 / バイオマーカー / トルーソー症候群 / マイクロRNA

Outline of Final Research Achievements

Cancer-associated ischemic stroke are caused by a hypercoagulation disorder related to malignant tumors. Our prospective cohort study for acute ischemic stroke patients with cancer have revealed that younger age, increased quartile of CA-125 levels, increased D-dimer levels, and infarcts in multiple vascular lesions were independently associated with the cancer-associated stroke. The cancer-associated stroke patients with poor outcome (mortality or recurrence of stroke during hospital) had increased CA-125 levels compared to those without. Hence, increased CA-125 levels were useful for diagnosis of cancer-associated stroke and associated with its poor clinical outcomes. The CA-125 is a marker used to monitor patients with ovarian cancer, but could be also a mucinous serum marker expressed in patients with various types of cancer. Therefore, it might reflect to the condition of cancer-associated hypercoagulation caused to ischemic stroke.

Free Research Field

脳卒中医学、脳神経内科学

Academic Significance and Societal Importance of the Research Achievements

悪性腫瘍関連脳梗塞は血液凝固異常を背景とした血栓症であり短期的に再発を繰り返し、治療に難渋することが多い。悪性腫瘍患者の深部静脈血栓症の治療には近年直接作用型経口抗凝固薬（DOAC）の有効性が示唆されつつあるが、悪性腫瘍患者がDOAC内服中に脳梗塞を起こす報告も散見され、DOACが悪性腫瘍関連脳梗塞に有効かは明らかでない。現状ではヘパリン皮下注を導入する症例が多いが、精神的・身体的苦痛を伴い障壁は大きい。悪性腫瘍患者における血栓症の一次予防、二次予防のリスク管理と最適な治療法確立が求められている。