title: Predictors of occult cancer in acute ischemic stroke patients.
abstract: BACKGROUND
  We investigated the prevalence of occult malignancy (OM) in acute ischemic stroke patients to evaluate if any biological marker could help to detect the presence of OM.
  
  
  METHODS
  We retrospectively reviewed all ischemic stroke patients during 48 months. We did not perform any screening for OM. Demographic data, vascular risk factors, routine blood chemistry with fibrinogen and C-reactive protein (CRP), National Institutes of Health Stroke Scale (NIHSS), and etiological subtype of stroke according to Trial of Org 10172 in Acute Stroke Treatment criteria were analyzed. The patients were divided into 2 groups (Non-OM versus OM).
  
  
  RESULTS
  We analyzed 631 patients with acute ischemic stroke. The mean age was 69.7 ± 12.7 years, and 59% were men. The distribution of vascular risk factors, etiological subgroups, and NIHSS was comparable between both groups. We detected 13 cases (2.1%) with OM, and this percentage was higher in patients with stroke of undetermined etiology (5.3%). We detected significant higher levels of fibrinogen and CRP in patients with stroke of undetermined cause with OM. Receiver operating characteristic curves showed a sensitivity of 75% and specificity of 96% for levels of CRP more than 20 mg/L, and a sensitivity of 67% and specificity of 91% for fibrinogen levels greater than 600 mg/dL.
  
  
  CONCLUSIONS
  OM was present in 2.1 % of overall patients, and 5.3% of patients with stroke of undetermined cause. Baseline levels of fibrinogen more than 600 mg/dL or CRP greater than 20 mg/L in patients with undetermined stroke might be good predictors of OM.
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain. Electronic address: lolacocho@gmail.com.
authors.forename: Dolores
authors.initials: D
authors.lastname: Cocho
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Gendre
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Anuncia
authors.initials: A
authors.lastname: Boltes
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Espinosa
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Ricciardi
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Pons
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Jimenez
authors.affiliation: Department of Neurology, Hospital General de Granollers, Universitat Internacional de Catalunya, Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Otermin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000150:complications*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000150:complications*
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: Stroke; cancer; ischemic stroke; occult malignancy