Usefulness of CEA and CA19-9 for detecting a previously undiagnosed cancer in patients with acute ischemic stroke
- Author:
Akiyuki Hiraga
;
Ikuo Kamitsukasa
;
Saiko Nasu
;
Satoshi Kuwabara
- Publication Type:Journal Article
- From:Neurology Asia
2013;18(2):153-159
- CountryMalaysia
- Language:English
-
Abstract:
Background: Ischemic stroke can occur in patients with an underlying or undiagnosed malignancy.
We aim to report the clinical features of ischemic stroke patients in whom a previously undiagnosed
cancer was detected after stroke onset. Methods: Clinical and laboratory records of 28 consecutive
ischemic stroke patients with cancer were reviewed retrospectively. The analysis was made focused
on the differences between patients who were already diagnosed as having cancer before ischemic
stroke (Group A) and those in whom a previously undiagnosed cancer was detected after ischemic
stroke onset (Group B). Results: There were 18 patients in the Group A and 10 in the Group B. In
Group B patients, the indicators that led to the detection of cancer were as follows: ascites (n=2), liver
enzyme elevation (n=2), anemia (n=2), hematemesis (n=1), hematochezia (n=1), and sore throat (n=1),
and autopsy (n=1). Nine of the 10 patients (90%) in Group B, and 6 of the 18 (33%) in Group A had
a gastrointestinal cancer. In Group B, 8 of the 9 patients showed elevated serum carcinoembryonic
antigen (CEA) and/or carbohydrate antigen 19-9 (CA19-9). Stroke relapse, prognosis, diffusion-weighted
imaging patterns and laboratory fi ndings were not different between the 2 groups.
Conclusions: Gastrointestinal cancer was frequent in ischemic stroke patients with newly diagnosed
malignancy after stroke onset in this study among Japanese patients. Physicians should be aware that
underlying cancer may be present particularly in ischemic stroke patients whose stroke etiology is
unclear or who have anemia or liver dysfunction. In such cases, measurements of CEA and CA19-9
levels are easy and useful screening for the detection of occult malignancies.
- Full text:P020150706462247357061.pdf
