Research Progress on the Pathogenesis and Preventive Treatment of Ischemic Stroke in Breast Cancer-related Ischemic Stroke

doi:10.12114/j.issn.1007-9572.2022.0198

Abstract

Abstract:

Breast cancer and ischemic stroke are two important diseases that endanger human health. More and more studies have shown that the incidence of breast cancer with ischemic stroke is higher than that of the general population, however, its pathogenesis, optimal treatment and prevention strategies are still unclear. This article summarized the evidence literature on the epidemiology, risk factors, clinical and imaging features, pathogenesis and prevention measures of breast cancer-related ischemic stroke, aiming to sort out the research progress of breast cancer-related ischemic stroke, as well as the potential strategies to solve the above problems.

Key words: Breast neoplasms, Ischemic stroke, Blood coagulation disorders, Review

摘要：

乳腺癌和缺血性卒中是危害人类健康的两大重要疾病，越来越多的研究表明乳腺癌伴缺血性卒中的发病率高于一般人群，然而其发病机制及最佳治疗、预防策略尚不明确。本文总结了关于乳腺癌相关缺血性卒中的流行病学、危险因素、临床表现及影像学特征、发病机制及防治措施的研究证据文献，旨在梳理乳腺癌相关缺血性卒中的研究进展，以及解决以上问题的潜在策略。

关键词: 乳腺肿瘤, 缺血性卒中, 血液凝固障碍, 综述

Xiaoyue SUN,Fengling WANG,Aihua WANG. Research Progress on the Pathogenesis and Preventive Treatment of Ischemic Stroke in Breast Cancer-related Ischemic Stroke[J]. Chinese General Practice, 2022, 25(29): 3710-3714. DOI: 10.12114/j.issn.1007-9572.2022.0198.
孙潇越,王凤玲,王爱华. 乳腺癌相关缺血性卒中发病机制及防治的研究进展[J]. 中国全科医学, 2022, 25(29): 3710-3714. DOI: 10.12114/j.issn.1007-9572.2022.0198.

References 68

[1]	NILSSON G, HOLMBERG L, GARMO H，et al. Increased incidence of stroke in women with breast cancer[J]. Eur J Cancer，2005，41(3):423-429. DOI：10.1016/j.ejca.2004.11.013.
[2]	ZAORSKY N G, ZHANG Y, TCHELEBI L T，et al. Stroke among cancer patients[J]. Nat Commun，2019，10(1):5172. DOI：10.1038/s41467-019-13120-6.
[3]	VALENTE-ACOSTA B, FLORES-GARCÍA M, GONZÁLEZ-ZÁRATE G，et al. Fibrinolytic activity of circulating microvesicles is associated with progression of breast cancer[J]. Tohoku J Exp Med，2020，250(2):121-128. DOI：10.1620/tjem.250.121.
[4]	MULDER M B, PROCTOR K G, VALLE E J，et al. Hypercoagulability after resection of thoracic malignancy：a prospective evaluation[J]. World J Surg，2019，43(12):3232-3238. DOI：10.1007/s00268-019-05123-7.
[5]	IKUSHIMA S, ONO R, FUKUDA K，et al. Trousseau's syndrome：cancer-associated thrombosis[J]. Jpn J Clin Oncol，2016，46(3):204-208. DOI：10.1093/jjco/hyv165.
[6]	CHI X S, ZHAO R L, PEI H T，et al. Diffusion-weighted imaging-documented bilateral small embolic stroke involving multiple vascular territories may indicate occult cancer：a retrospective case series and a brief review of the literature[J]. Aging Med （Milton），2020，3(1):53-59. DOI：10.1002/agm².12105.
[7]	ROGERS L R. Cerebrovascular complications in patients with cancer[J]. Semin Neurol，2004，24(4):453-460. DOI：10.1055/s-2004-861539.
[8]	ADAMS H P Jr. Cancer and cerebrovascular disease[J]. Curr Neurol Neurosci Rep，2019，19(10):73. DOI：10.1007/s11910-019-0985-0.
[9]	CHENG X M, QIN Q X, LU L Z，et al. The independent risks and specific biomarker of breast cancer-related ischemic stroke[J]. Int J Neurosci，2021，131(2):135-143. DOI：10.1080/00207454.2020.1733562.
[10]	NAVI B B, SINGER S, MERKLER A E，et al. Cryptogenic subtype predicts reduced survival among cancer patients with ischemic stroke[J]. Stroke，2014，45(8):2292-2297. DOI：10.1161/STROKEAHA.114.005784.
[11]	PEGA F, NÁFRÁDI B, MOMEN N C，et al. Global，regional，and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries，2000—2016：a systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury[J]. Environ Int，2021，154:106595. DOI：10.1016/j.envint.2021.106595.
[12]	SUNG H, FERLAY J, SIEGEL R L，et al. Global cancer statistics 2020：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin，2021，71(3):209-249. DOI：10.3322/caac.21660.
[13]	TACCONE F S, JEANGETTE S M, BLECIC S A. First-ever stroke as initial presentation of systemic cancer[J]. J Stroke Cerebrovasc Dis，2008，17(4):169-174. DOI：10.1016/j.jstrokecerebrovasdis.2008.01.007.
[14]	NAVI B B, IADECOLA C. Ischemic stroke in cancer patients：a review of an underappreciated pathology[J]. Ann Neurol，2018，83(5):873-883. DOI：10.1002/ana.25227.
[15]	DETREMERIE C, TIMMERMANS F, DE PAUW M，et al. Stroke due to non-bacterial thrombotic endocarditis as initial presentation of breast invasive ductal carcinoma[J]. Acta Clin Belg，2017，72(4):268-273. DOI：10.1080/17843286.2016.1219012.
[16]	ARVOLD N D, HSU L, CHEN W Y，et al. Marantic endocarditis with cardioembolic strokes mimicking leptomeningeal metastases in breast cancer[J]. J Clin Oncol，2011，29(29):e743-746. DOI：10.1200/JCO.2011.36.4190.
[17]	VAN HERK-SUKEL M P, SHANTAKUMAR S, KAMPHUISEN P W，et al. Myocardial infarction，ischaemic stroke and pulmonary embolism before and after breast cancer hospitalisation. A population-based study[J]. Thromb Haemost，2011，106(1):149-155. DOI：10.1160/TH10-12-0778.
[18]	ABDELSALAM M, ABU-HEGAZY M, EL-HADAAD H A，et al. Pathophysiology，mechanism，and outcome of ischemic stroke in cancer patients[J]. J Stroke Cerebrovasc Dis，2020，29(11):105299. DOI：10.1016/j.jstrokecerebrovasdis.2020.105299.
[19]	SELVIK H A, THOMASSEN L, LOGALLO N，et al. Prior cancer in patients with ischemic stroke：the Bergen NORSTROKE study[J]. J Stroke Cerebrovasc Dis，2014，23(5):919-925. DOI：10.1016/j.jstrokecerebrovasdis.2013.07.041.
[20]	DEARBORN J L, URRUTIA V C, ZEILER S R. Stroke and cancer- a complicated relationship[J]. J Neurol Transl Neurosci，2014，2(1):1039.
[21]	QUINTAS S, ROGADO J, GULLÓN P，et al. Predictors of unknown cancer in patients with ischemic stroke[J]. J Neurooncol，2018，137(3):551-557. DOI：10.1007/s11060-017-2741-0.
[22]	FALANGA A, MARCHETTI M, VIGNOLI A. Coagulation and cancer：biological and clinical aspects[J]. J Thromb Haemost，2013，11(2):223-233. DOI：10.1111/jth.12075.
[23]	MELAS N. Trousseau's syndrome：a combination of cancer and hypercoagulability[J]. Lakartidningen，2020，117:FTPY.
[24]	LIGIBEL J A, JAMES O'MALLEY A, FISHER M，et al. Risk of myocardial infarction，stroke，and fracture in a cohort of community-based breast cancer patients[J]. Breast Cancer Res Treat，2012，131(2):589-597. DOI：10.1007/s10549-011-1754-1.
[25]	LAI S W, LIN C L, LIAO K F. Tamoxifen use correlates with increased risk of the first episode of ischemic cerebrovascular disease in older women with breast cancer：a case-control study in Taiwan[J]. Front Pharmacol，2017，8:742. DOI：10.3389/fphar.2017.00742.
[26]	ROSELL J, NORDENSKJÖLD B, BENGTSSON N O，et al. Time dependent effects of adjuvant tamoxifen therapy on cerebrovascular disease：results from a randomised trial[J]. Br J Cancer，2011，104(6):899-902. DOI：10.1038/bjc.2011.45.
[27]	SUND M, GARCIA-ARGIBAY M, GARMO H，et al. Aromatase inhibitors use and risk for cardiovascular disease in breast cancer patients：a population-based cohort study[J]. Breast，2021，59:157-164. DOI：10.1016/j.breast.2021.07.004.
[28]	BAO L, ZHANG S Y, GONG X Y，et al. Trousseau syndrome related cerebral infarction：clinical manifestations，laboratory findings and radiological features[J]. J Stroke Cerebrovasc Dis，2020，29(9):104891. DOI：10.1016/j.jstrokecerebrovasdis.2020.104891.
[29]	SELVIK H A, BJERKREIM A T, THOMASSEN L，et al. When to screen ischaemic stroke patients for cancer[J]. Cerebrovasc Dis，2018，45(1/2):42-47. DOI：10.1159/000484668.
[30]	SELVIK H A, THOMASSEN L, BJERKREIM A T，et al. Cancer-associated stroke：the Bergen NORSTROKE study[J]. Cerebrovasc Dis Extra，2015，5(3):107-113. DOI：10.1159/000440730.
[31]	SCHWARZBACH C J, FATAR M, EISELE P，et al. DWI lesion patterns in cancer-related stroke—specifying the phenotype[J]. Cerebrovasc Dis Extra，2015，5(3):139-145. DOI：10.1159/000439549.
[32]	DARDIOTIS E, ALOIZOU A M, MARKOULA S，et al. Cancer-associated stroke：pathophysiology，detection and management （Review）[J]. Int J Oncol，2019，54(3):779-796. DOI：10.3892/ijo.2019.4669.
[33]	GRAZIOLI S, PACIARONI M, AGNELLI G，et al. Cancer-associated ischemic stroke：a retrospective multicentre cohort study[J]. Thromb Res，2018，165:33-37. DOI：10.1016/j.thromres.2018.03.011.
[34]	RÜCKERL R, SCHNEIDER A, HAMPEL R，et al. Association of novel metrics of particulate matter with vascular markers of inflammation and coagulation in susceptible populations-results from a panel study[J]. Environ Res，2016，150:337-347. DOI：10.1016/j.envres.2016.05.037.
[35]	CAMPELLO E, SPIEZIA L, RADU C M，et al. Microparticles as biomarkers of venous thromboembolic events[J]. Biomark Med，2016，10(7):743-755. DOI：10.2217/bmm-2015-0063.
[36]	GUO Y J, CHANG M H, CHEN P L，et al. Predictive value of plasma （D）-dimer levels for cancer-related stroke：a 3-year retrospective study[J]. J Stroke Cerebrovasc Dis，2014，23(4):e249-254. DOI：10.1016/j.jstrokecerebrovasdis.2013.10.022.
[37]	KONO T, OHTSUKI T, HOSOMI N，et al. Cancer-associated ischemic stroke is associated with elevated D-dimer and fibrin degradation product levels in acute ischemic stroke with advanced cancer[J]. Geriatr Gerontol Int，2012，12(3):468-474. DOI：10.1111/j.1447-0594.2011.00796.x.
[38]	FERNANDES C J, MORINAGA L T K, ALVES J L Jr，et al. Cancer-associated thrombosis：the when，how and why[J]. Eur Respir Rev，2019，28(151):180119. DOI：10.1183/16000617.0119-2018.
[39]	GORDON S G, MIELICKI W P. Cancer procoagulant：a factor X activator，tumor marker and growth factor from malignant tissue[J]. Blood Coagul Fibrinolysis，1997，8(2):73-86.
[40]	KAŹMIERCZAK M, LEWANDOWSKI K, WOJTUKIEWICZ M Z，et al. Cancer procoagulant in patients with adenocarcinomas[J]. Blood Coagul Fibrinolysis，2005，16(8):543-547. DOI：10.1097/01.mbc.0000188413.32859.b2.
[41]	MIELICKI W P, TENDERENDA M, RUTKOWSKI P，et al. Activation of blood coagulation and the activity of cancer procoagulant （EC 3.4.22.26） in breast cancer patients[J]. Cancer Lett，1999，146(1):61-66. DOI：10.1016/s0304-3835(99)00230-x.
[42]	姜季委，陈昱彤，彭乾，等. 癌症相关缺血性卒中研究进展[J]. 中国现代神经疾病杂志，2020，20(4):359-365. DOI：10.3969/j.issn.1672-6731.2020.04.017.
[43]	LYSOV Z, DWIVEDI D J, GOULD T J，et al. Procoagulant effects of lung cancer chemotherapy：impact on microparticles and cell-free DNA[J]. Blood Coagul Fibrinolysis，2017，28(1):72-82. DOI：10.1097/MBC.0000000000000546.
[44]	FALANGA A, SCHIEPPATI F, RUSSO D. Cancer tissue procoagulant mechanisms and the hypercoagulable state of patients with cancer[J]. Semin Thromb Hemost，2015，41(7):756-764. DOI：10.1055/s-0035-1564040.
[45]	MINETTI G, BERNECKER C, DORN I，et al. Membrane rearrangements in the maturation of circulating human reticulocytes[J]. Front Physiol，2020，11:215. DOI：10.3389/fphys.2020.00215.
[46]	TESSELAAR M E, ROMIJN F P, VAN DER LINDEN I K，et al. Microparticle-associated tissue factor activity：a link between cancer and thrombosis? [J]. J Thromb Haemost，2007，5(3):520-527. DOI：10.1111/j.1538-7836.2007.02369.x.
[47]	MARCHETTI M, GIACCHERINI C, MASCI G，et al. Thrombin generation predicts early recurrence in breast cancer patients[J]. J Thromb Haemost，2020，18(9):2220-2231. DOI：10.1111/jth.14891.
[48]	CASTANEDA S A, STRASSER J. Updates in the treatment of breast cancer with radiotherapy[J]. Surg Oncol Clin N Am，2017，26(3):371-382. DOI：10.1016/j.soc.2017.01.013.
[49]	ADDISON D, LAWLER P R, EMAMI H，et al. Incidental statin use and the risk of stroke or transient ischemic attack after radiotherapy for head and neck cancer[J]. J Stroke，2018，20(1):71-79. DOI：10.5853/jos.2017.01802.
[50]	WOODWARD W A, GIORDANO S H, DUAN Z G，et al. Supraclavicular radiation for breast cancer does not increase the 10-year risk of stroke[J]. Cancer，2006，106(12):2556-2562. DOI：10.1002/cncr.21943.
[51]	GERVASO L, MONTERO A J, JIA X F，et al. Venous thromboembolism in breast cancer patients receiving cyclin-dependent kinase inhibitors[J]. J Thromb Haemost，2020，18(1):162-168. DOI：10.1111/jth.14630.
[52]	MAHAJAN A, BRUNSON A, WHITE R，et al. The epidemiology of cancer-associated venous thromboembolism：an update[J]. Semin Thromb Hemost，2019，45(4):321-325. DOI：10.1055/s-0039-1688494.
[53]	MITOMI M, KIMURA K, IGUCHI Y，et al. A case of stroke due to tumor emboli associated with metastatic cardiac liposarcoma[J]. Intern Med，2011，50(14):1489-1491. DOI：10.2169/internalmedicine.50.5071.
[54]	UNER A, DOGAN M, SAL E，et al. Stroke and recurrent peripheral embolism in left atrial myxoma[J]. Acta Cardiol，2010，65(1):101-103. DOI：10.2143/AC.65.1.2045899.
[55]	POWERS W J, RABINSTEIN A A, ACKERSON T，et al. Guidelines for the early management of patients with acute ischemic stroke：2019 update to the 2018 guidelines for the early management of acute ischemic stroke：a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Stroke，2019，50(12):e344-418. DOI：10.1161/STR.0000000000000211.
[56]	NAM K W, KIM C K, KIM T J，et al. Intravenous thrombolysis in acute ischemic stroke with active cancer[J]. Biomed Res Int，2017，2017:4635829. DOI：10.1155/2017/4635829.
[57]	MASRUR S, ABDULLAH A R, SMITH E E，et al. Risk of thrombolytic therapy for acute ischemic stroke in patients with current malignancy[J]. J Stroke Cerebrovasc Dis，2011，20(2):124-130. DOI：10.1016/j.jstrokecerebrovasdis.2009.10.010.
[58]	SOBOLEWSKI P, BROLA W, SZCZUCHNIAK W，et al. Safety of intravenous thrombolysis for acute ischaemic stroke including concomitant neoplastic disease sufferers - experience from Poland[J]. Int J Clin Pract，2015，69(6):666-673. DOI：10.1111/ijcp.12586.
[59]	CHO B H, YOON W, KIM J T，et al. Outcomes of endovascular treatment in acute ischemic stroke patients with current malignancy[J]. Neurol Sci，2020，41(2):379-385. DOI：10.1007/s10072-019-04103-y.
[60]	BHATIA S, KU A, PU C F，et al. Endovascular mechanical retrieval of a terminal internal carotid artery breast tumor embolus[J]. J Neurosurg，2010，112(3):572-574. DOI：10.3171/2009.6.JNS09221.
[61]	LEE V, JAIRAM V, YU J B，et al. Nationwide patterns of hemorrhagic stroke among patients hospitalized with brain metastases：influence of primary cancer diagnosis and anticoagulation[J]. Sci Rep，2020，10(1):10084. DOI：10.1038/s41598-020-67316-8.
[62]	SONG S H, KIM J H, LEE J H，et al. Elevated blood viscosity is associated with cerebral small vessel disease in patients with acute ischemic stroke[J]. BMC Neurol，2017，17(1):20. DOI：10.1186/s12883-017-0808-3.
[63]	齐泓竹，刘强. 血栓弹力图与常规凝血试验在急性缺血性卒中的应用价值[J]. 中国现代医生，2021，59(1):35-39.
[64]	李真，武丹娜. 恶性肿瘤合并缺血性脑卒中的研究进展[J]. 临床荟萃，2016，31(7):809-812. DOI：10.3969/j.issn.1004-583X.2016.07.030.
[65]	李永琴，陈飞，张微微，等. 脑微出血与脑梗死的相关性研究[J]. 中华老年心脑血管病杂志，2017，19(6):615-618. DOI：10.3969/j.issn.1009-0126.2017.06.016.
[66]	宋杨，潘海松. 应用基线MRI特征构建缺血性脑卒中患者使用抗凝药后脑出血预测模型[J]. 新医学，2020，51(10):774-779. DOI：10.3969/j.issn.0253-9802.2020.10.009.
[67]	MATHEWS L, ISHIGAMI J, DING N，et al. Cardiac biomarkers and subsequent risk of hospitalization with bleeding in the community：atherosclerosis risk in communities study[J]. J Am Heart Assoc，2020，9(5):e013560. DOI：10.1161/JAHA.119.013560.
[68]	HIJAZI Z, OLDGREN J, LINDBÄCK J，et al. The novel biomarker-based ABC （age，biomarkers，clinical history）-bleeding risk score for patients with atrial fibrillation：a derivation and validation study[J]. Lancet，2016，387(10035):2302-2311. DOI：10.1016/S0140-6736(16)00741-8.