关键词: 胰腺肿瘤, 癌, 脑梗死, CA-19-9抗原, D-二聚体, 临床特点, 发病机制

Abstract: Objective　To investigate the clinical features and possible pathogenesis of pancreatic cancer-related cerebral infarction (PCCI). Methods　Patients with pancreatic cancer-related cerebral infarction treated in the first affiliated hospital and the affiliated cancer hospital of Guangxi Medical University were included from January 2008 to December 2018. Patients with pancreatic cancer complicated with acute cerebral infarction while without traditional stroke factors were included in (PCCI) group. The age and sex matched patients with pancreatic cancer in the same period were chosen as pancreatic cancer (PC) group according to the ratio of 1∶1. The clinical data were analyzed between two groups. Results　A total of 30 patients were included in the PCCI group. The levels of plasma D-dimer, absolute value of neutrophils, CA125 and CA199 were significantly higher in PCCI group than those in PC group (P＜0.05 or P＜0.01). In the PCCI group, 24 (80.00%) patients presented with multiple lesions in multiple arterial territories. The diameters of the largest lesions were as follows:≤2 cm in 14 patients (46.67%) and 2-5 cm in 10 patients (33.33%). Twenty patients (66.67%) developed acute cerebral infarction within 6 months after the diagnosis of pancreatic cancer. Three patients (10.00%) had acute cerebral infarction as the initial manifestation and then were diagnosed as pancreatic cancer during hospitalization. The TOAST classification of cerebral infarction was mainly minor arterial occlusion and unknown cause. Multivariate Logistic regression analysis showed that the levels of plasma D-dimer＞0.5 mg/L and CA199＞120 mg/L were independent risk factors for PCCI. Conclusion　The mechanism of pancreatic cancer-related cerebral infarction may be related to the blood hypercoagulation and the formation of microthrombosis in blood vessels.

Key words: pancreatic neoplasms, carcinoma, brain infraction, CA-19-9 antigen, D-dimer, clinical features, pathogenesis