1.The clinical features and possible pathogenesis of acute ischemic stroke in renal cell cancer patients
Haihong JIANG ; Chao QIN ; Gelun HUANG ; Qiuhong LU ; Ziqiang XIAN ; Tianxin DENG ; Zhijian LIANG
Chinese Journal of Postgraduates of Medicine 2017;40(6):481-485
Objective To study the clinical features and possible pathogenesis of acute ischemic stroke in renal cell cancer patients. Methods The clinical data from in-hospital patients with renal cell cancer who developed acute ischemic stroke were collected, including the patients with renal cell cancer who developed acute ischemic stroke during anti-cancer therapies and those patients with acute ischemic stroke who were firstly diagnosed to have renal cell cancer during anti-stroke therapies between January 2003 and December 2015. Results A total of 2516 patients with renal cell cancer were screened, and there were 36 patients (1.43%) with acute ischemic stroke. Out of the 36 patients, there were 29 men (80.56%) and 7 women (19.44%). Their age ranged from 45 to 68 years, with a average age of (65.11 ± 14.77) years. Eight patients (22.22%) had some conventional cardiovascular risk factors, while the other 28 patients (77.78%) had no such risk factors. Magnetic resonance imaging (MRI) scans at the acute stage of ischemic stroke were carried out for all these patients. Based on the diffusion weighted imaging (DWI) of MRI, 8 patients (22.22%) had single lesion and 28 patients (77.78%) had multiple lesions in different arterial territories in their brains. The pathological types of renal cell cancer were:suprarenal epithelioma (18 patients, 50.00%), papillary cell carcinoma (12 patients, 33.33%) and chromophobe renal cell carcinoma (6 patients, 16.67%). Metastases were found 10 patients (27.78%) out of the 36 patients. Blood biochemical examination showed that 28 patients had elevated plasma D-dimer level, 22 patients had elevated plasma cancer antigen (CA)125 level, and 17 patients had elevated plasma carcinoembryonic antigen (CEA) levels. Conclusions It is suggested that the renal cell cancer associated stroke is characterized by lacking of traditional risk factors and having multiple lesions in brain;and that the elevated plasma D-dimer, CA125 and CEA levels may lead to hypercoagulable state and lead to ischemic stroke eventually .
2.Clinical features and phathogenesis of cerebral venous sinus thrombosis in patients with malignancy
Ziqiang XIAN ; Chao QIN ; Li CHEN ; Haihong JIANG ; Gelun HUANG ; Tianxin DENG ; Zhijian LIANG
Chinese Journal of Postgraduates of Medicine 2018;41(4):311-316
Objective To investigate the clinical features of cerebral venous sinus thrombosis (CVST)in patients with malignancy as well as its underlying pathogenesis. Methods The clinical data, including clinical presentation, laboratory results, neurological images were retrospectively reviewed in hospital patients with active malignant tumor and cerebral venous thrombosis from January 2006 to December 2016. Results Among the 586 CVST patients, 24 patients (4.10%) were with malignant tumor. Among these 24 patients, there were 8 males and 16 females with an average age of (39.88 ± 21.71) years old. Four patients (16.67%) had the risk factors of cerebral venous sinus thrombosis, while the other 20 patients(83.33%)had not any such risk factors.At the symptom onset of CVST, 22 patients(91.67%) had headache and focal neurological deficit, such as limbs weakness and numbness. The common substyles of malignant tumor were lung cancer (33.33%), breast cancer (29.17%)and acute lymphocytic leukemia(20.83%).Most patients(58.33%)were found to have cerebral metastasis.22 patients (91.67%) had elevated plasma D-dimmer level, and 19 patients (79.17%) had elevated plasma cancer biochemical marker levels.Conclusions Cancer-related CVST had the features including lacking conventional risk factors, elevated plasma D-dimmer and cancer biochemical marker levels.Cerebral metastasis and hypercoagulable state may be responsible for the pathogenesis of CVST.
3.The expression of IL-1β in peripheral blood and PD-1 in tissue and its influence on the prognosis of patients with esophageal cancer and its clinical significance
Xian WANG ; Ziqiang SHANG ; Dong YANG ; Hui YANG
Journal of China Medical University 2023;52(12):1082-1086
Objective To detect the expressions of interleukin-1β(IL-1β)in peripheral blood and programmed death molecule 1(PD-1)in esophageal cancer tissues and to analyze their influence on clinicopathological features and prognosis of patients.Methods A total of 127 patients with esophageal cancer who underwent surgical treatment at the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to May 2020 were collected and divided into two groups:the survival group(n= 95)and the death group(n= 32),based on their survival status 3 years after surgery.Clinical data of the patients were collected.The expressions of PD-1 and programmed death ligand 1(PD-L1)in esophageal cancer tissues were detected through immunohistochemistry,while the levels of IL-6,IL-1β,and tumor necrosis factor-α(TNF-α)in peripheral blood were measured using enzyme-linked immunosorbent assay(ELISA).Cox regression analysis was performed to identify the risk factors for death 3 years after surgery.The 3-year Kaplan-Meier survival curves of patients with different expressions of IL-1βand PD-1 were plotted,and the survival rates among the three groups were compared using the log-rank test.Results In the death group,the proportions of patients with age≥60 years old,lymph node metastasis,infiltration into the muscle layer,tumor diameter>3 cm,IL-1β high level,TNF-αhigh level,and PD-1 positive expression were higher than those in the survival group.Conversely,the proportions of patients with high IL-6 levels were lower than those in the survival group,with statistically significant differences between the groups(P<0.05).Infiltration into the myometrium,tumor diameter>3 cm,high IL-1β level,and PD-1 positive expression were identified as independent risk factors for postoperative death.The 3-year survival rates were 92.4%,13.3%,and 84.2%for patients in the normal IL-1β+PD-1 negative group,high IL-1β+PD-1 positive group,and normal IL-1β+PD-1 positive group/high IL-1β+PD-1 negative group,respectively.Significant differences existed between the groups(χ2=82.318,P<0.01),with the highest survival rate observed in the normal IL-1β+ PD-1 negative group and the lowest in the high IL-1β+ PD-1 positive group.Conclusion Positive expression of PD-1 and a high level of IL-1βwere identified as independent risk factors for death in patients with esophageal cancer.Notably,patients with positive expression of PD-1+high levels of IL-1βexhibited a low survival rate.