Increased risk of brain cancer incidence in stroke patients

A clinical case series, population-based and longitudinal follow-up study

Chih Wei Chen, Tain Junn Cheng, Chung Han Ho, Jhi Joung Wang, Shih Feng Weng, Ya Chin Hou, Hung-Chi Cheng, Chung Ching Chio, Yan-Shen Shan, Wen-Tsan Chang

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 1α (HIF-1α) 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.

Original languageEnglish
Pages (from-to)108989-108999
Number of pages11
JournalOncotarget
Volume8
Issue number65
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Brain Neoplasms
Stroke
Incidence
Population
Confidence Intervals
Glioblastoma
Glioma
Hypoxia-Inducible Factor 1
Taiwan
Longitudinal Studies
Neoplasms
Neck
Head
Magnetic Resonance Imaging
Staining and Labeling
Bone and Bones
Control Groups
Skin
Brain

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

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. / Increased risk of brain cancer incidence in stroke patients : A clinical case series, population-based and longitudinal follow-up study. In: Oncotarget. 2017 ; Vol. 8, No. 65. pp. 108989-108999.
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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 1α (HIF-1α) 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.",
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Increased risk of brain cancer incidence in stroke patients : A clinical case series, population-based and longitudinal follow-up study. / 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.

In: Oncotarget, Vol. 8, No. 65, 01.01.2017, p. 108989-108999.

Research output: Contribution to journalArticle

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AU - Chen, Chih Wei

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AU - Chang, Wen-Tsan

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