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Abstract
Aim
This retrospective study was designed to investigate the independent risks and specific biomarker for breast cancer-related ischemic stroke (BCRS).
Methods
Clinical features and laboratory findings were compared between BCRS group and breast cancer group without stroke, and further multivariate analyses were performed to predict independent risks factors for BCRS patients. A receiver operator characteristic (ROC) curve analysis was configured to estimate the diagnostic efficacy of each independent risk and the product of these risks and to obtain the optimal cut-off value of diagnosis, which was termed the BCRS Index.
Results
BCRS patients had elevated plasma D-dimer and CA153 levels and platelet-to-lymphocyte ratio (PLR), as well as more patients received endocrine therapy (all p ＜ 0.05). Moreover, multivariate analysis revealed that D-dimer levels (odds ratio [OR]: 1.002; 95% confidence interval [CI]: 1.001–1.003; p = 0.000), CA153 levels (OR: 1.005; 95% CI: 1.001–1.008; p = 0.007), PLR (OR: 1.010; 95% CI: 1.004–1.015; p = 0.001), and endocrine therapy (OR: 1.268; 95% CI: 1.087–1.479; p = 0.003) were identified as independent risks of BCRS. Furthermore, ROC analysis displayed that the product of risks had the best diagnostic efficacy, of which the area under the curve was 0.846 ± 0.28. The optimum cut-off point was 2.37 × 106/mL, which was termed the BCRS Index with higher diagnostic accuracy and validity.
Conclusions
Endocrine therapy, as well as elevated plasma D-dimer and CA153 levels and PLR values may be independent risks for BCRS. Furthermore, BCRS Index should be served as a novel specific biomarker for BCRS, which is useful to distinguish BCRS for clinicians.
Acknowledgements
We would like to thank all colleagues in the medical records departments of each participating hospital for their assistance in screening medical records.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics approval and consent to participate
The present study received ethical approval by the ethics committee of The First Affiliated Hospital of Guangxi Medical University, and informed consent forms were signed by all patients upon admission.
Additional information
Funding
Notes on contributors
Xuemin Cheng
Xuemin Cheng and Zhijian Liang conceived and designed the research; Xuemin Cheng collected the data and drafted the initial manuscript; Qixiong Qin, Lizhi Lu and Chunyong Chen helped to analyze the data and write the article; Yunfei Wei, Dacheng Wang, Haihua Li, Guohui Li, Hongbin Liang, and Shengyu Li helped to collect the data; Daobin Cheng and Zhijian Liang critically revised the manuscript; Zhijian Liang provided financial support for this work; all authors read and approved the final manuscript.