Deng XH, Li J, Chen SJ, Xie YJ, Zhang J, Cen GY, Song YT, Liang ZJ. Clinical features of intracerebral hemorrhage in patients with colorectal cancer and its underlying pathogenesis. World J Gastrointest Oncol 2021; 13(12): 2180-2189 [PMID: 35070050 DOI: 10.4251/wjgo.v13.i12.2180]
Corresponding Author of This Article
Zhi-Jian Liang, MD, PhD, Professor, Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, No. 22 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. lzj200415@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xu-Hui Deng, Shi-Jian Chen, Yi-Ju Xie, Jian Zhang, Geng-Yu Cen, Yi-Ting Song, Zhi-Jian Liang, Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Xu-Hui Deng, Department of Neurology, The Affiliated Yuebei People’s Hospital of Shantou University Medical College, Shaoguan 512025, Guangdong Province, China
Jing Li, Department of General Medicine, The Affiliated Cancer Center of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Deng XH and Liang ZJ conceived and designed the study; Deng XH collected the data and drafted the manuscript; Li J, Chen SJ, Xie YJ, Zhang J, Cen GY and Song YT helped to collect the data; Li J and Chen SJ analyzed the results; Liang ZJ critically revised the manuscript and provided financial support for this work; all the authors have read the manuscript and approved the final version.
Supported byThe Foundation of Prevention and Control of Chronic Diseases in Central-South China (Guangxi), No. 2018YFC1311305; and the Foundation of Science and Technology Plan Projects of Qingxiu District of Nanning, No. 2020043.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. For full disclosure, the details of the study are published on the home page of the First Affiliated Hospital of Guangxi Medical University.
Conflict-of-interest statement: All authors have no conflict of interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Jian Liang, MD, PhD, Professor, Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, No. 22 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. lzj200415@126.com
Received: July 5, 2021 Peer-review started: July 5, 2021 First decision: July 29, 2021 Revised: August 10, 2021 Accepted: September 15, 2021 Article in press: September 15, 2021 Published online: December 15, 2021 Processing time: 162 Days and 14.6 Hours
Abstract
BACKGROUND
The diagnosis of both cancer and intracerebral hemorrhage (ICH) in the same patient is not uncommon, but the clinical features and pathogenesis of patients with colorectal cancer (CRC) and ICH are still not well known.
AIM
To investigate the clinical features and underlying pathogenesis of ICH in patients with CRC.
METHODS
A retrospective review of CRC patients complicated with ICH from three centers between January 2014 and December 2020 was performed. Clinical data such as laboratory examinations, imaging features, prognosis, and underlying pathogenesis were analyzed.
RESULTS
Of 16673 identified CRC patients, 20 (0.12%) suffered from ICH. There were 13 males and 7 females, with an average age (mean ± SD) of 68.45 ± 10.66 years. Fourteen patients (70%) had distant metastases and most patients (85%) showed an elevation of one or more cancer biomarkers. The hemorrhagic lesions in 13 patients (65%) were in the intracerebral lobe. Four patients were completely dependent and 4 died within 30 days after hemorrhage. Intratumoral hemorrhage (50%) and coagulopathy (50%) accounted for the majority of hemorrhages.
CONCLUSION
Patients with ICH and CRC often have clinical features with lobar hemorrhage, distant metastases and poor prognosis. Intratumoral hemorrhage and coagulopathy are the main causes of ICH in patients with CRC.
Core Tip: The association between cancer and intracerebral hemorrhage (ICH) has long been studied, however little attention has been paid to the hemorrhagic cerebrovascular events in patients with colorectal cancer (CRC). CRC has been reported to increase the risk of ICH. The present study retrospectively analyzed the clinical data of patients with CRC and ICH, and indicated that intratumoral hemorrhage and coagulopathy were the main causes of ICH in CRC patients.
