Increased risk of brain cancer incidence in stroke patients: a clinical case series, population-based and longitudinal follow-up study

doi:10.18632/oncotarget.22480

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Title:	Increased risk of brain cancer incidence in stroke patients: a clinical case series, population-based and longitudinal follow-up study
Authors:	Chen, Chih-Wei Cheng, Tain-Junn Ho, Chung-Han Wang, Jhi-Joung Weng, Shih-Feng Hou, Ya-Chin Cheng, Hung-Chi Chio, Chung-Ching Shan, Yan-Shen Chang, Wen-Tsan
Contributors:	Natl Cheng Kung Univ, Coll Med, Inst Clin Med Chi Mei Fdn Med Ctr, Dept Surg, Div Neurosurg Chia Nan Univ Pharm & Sci, Dept Occupat Safety & Health, Inst Ind Safety & Disaster Prevent, Coll Sustainable Environm Chi Mei Fdn Med Ctr, Dept Neurol & Occupat Med Chi Mei Fdn Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Chi Mei Fdn Med Ctr, Dept Anesthesiol Kaohsiung Med Univ, Dept Hlth Care Adm & Med Informat Natl Cheng Kung Univ, Dept Biochem & Mol Biol, Coll Med Natl Cheng Kung Univ, Div Gen Surg, Dept Surg, Coll Med
Keywords:	stroke ischemic stroke brain cancer glioblastoma mutiforme (GBM) nationwide population-based cohort
Date:	2017-12-12
Issue Date:	2018-11-30 15:55:16 (UTC+8)
Publisher:	Impact Journals Llc
Abstract:	Stroke and brain cancer are two distinct diseases. However, the relationship between both diseases has rarely been examined. This study investigated the longitudinal risk for developing brain cancer in stroke patients. To study this, we first reviewed the malignant gliomas previously with or without stroke using brain magnetic resonance imaging (MRI) images and the past histories. Two ischemic stroke patients before the malignant glioma were identified and belonged to the glioblastoma mutiforme (GBM). Particularly, both GBM specimens displayed strong hypoxia-inducible factor 1 alpha (HIF-1 alpha) expression in immunohistochemical (IHC) staining. To elucidate the significance of this relationship, we then used a nationwide population-based cohort in Taiwan to investigate the risk for the incidence of brain cancer in patients previously with or without stroke. The incidence of all tumors in the stroke group was lower than that in the control group with an adjusted hazard ratio (HR) of 0.79 (95% confidence interval [CI]: 0.74-0.84) in both gender and age older than 60 years. But the stroke patients had higher risk of developing only brain cancer with an adjusted HR of 3.09 (95% CI: 1.80-5.30), and otherwise had lower risk of developing head and neck, digestive, respiratory, bone and skin, as well as other tumors, all with p< 0.05. After stratification by gender and age, the female and aged 40-60 year old stroke patients had higher risk of developing brain cancer with an adjusted HR of 7.41 (95% CI: 3.30-16.64) and 16.34 (95% CI: 4.45-62.13), respectively, both with p<0.05. Patients with stroke, in particular female and age 40-60 years old, have an increased risk for developing brain cancer.
Relation:	Oncotarget, v.8, n.65, pp.108989-108999
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles [Dept. of Occupational Safety] Periodical Articles

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