Small Vessel Ischemic Disease of the Brain and Brain Metastases in Lung Cancer Patients 英文参考文献.docVIP

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Small Vessel Ischemic Disease of the Brain and Brain Metastases in Lung Cancer Patients 英文参考文献.doc

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Small Vessel Ischemic Disease of the Brain and Brain Metastases in Lung Cancer Patients 英文参考文献

SmallVesselIschemicDiseaseoftheBrainandBrain MetastasesinLungCancerPatients PeterJ.Mazzone1*,NicolaMarchi4,VinceFazio4,J.MichaelTaylor2,ThomasMasaryk2,LukeBury2, TarekMekhail3,DamirJanigro4 1RespiratoryInstitute,TheClevelandClinic,Cleveland,Ohio,UnitedStatesofAmerica,2NeurologicalInstitute,TheClevelandClinic,Cleveland,Ohio,UnitedStatesof America,3FloridaHospitalCancerInstitute,Orlando,Florida,UnitedStatesofAmerica,4CellBiology,TheClevelandClinic,Cleveland,Ohio,UnitedStatesofAmerica Abstract Background: Brainmetastases occur commonly in patients with lung cancer. Small vessel ischemic disease is frequently foundwhenimagingthebraintodetectmetastases.Weaimedtodetermineifthepresenceofsmallvesselischemicdisease (SVID)ofthebrainisprotectiveagainstthedevelopmentofbrainmetastasesinlungcancerpatients. Methodology/Principal Findings: A retrospective cohort of 523 patients with biopsy confirmed lung cancer who had received magnetic resonance imaging of the brain as part of their standard initial staging evaluation was reviewed. Informationcollectedincludeddemographics, comorbidities,detailsofthelungcancer,andthepresenceofSVIDofthe brain. A portion of the cohort had the degree of SVID graded. The primary outcome measure was the portion of study subjectswithandwithoutSVIDofthebrainwhohadevidenceofbrainmetastasesatthetimeofinitialstagingoftheirlung cancer.109patients(20.8%)hadevidenceofbrainmetastasesatpresentationand345(66.0%)hadevidenceofSVID.13.9% ofthosewithSVIDand34.3%ofthosewithoutSVIDpresentedwithbrainmetastases(p,0.0001).Inamodelincludingage, diabetesmellitus,hypertension,hyperlipidemia,andtobaccouse,SVIDofthebrainwasfoundtobetheonlyprotective factoragainstthedevelopmentofbrainmetastases,withanORof0.31(0.20,0.48;p,0.001).ThegradeofSVIDwashigher inthosewithoutbrainmetastases. Conclusions/Significance: These findings suggest that vascular changes in the brain are protective against the developmentofbrainmetastasesinlungcancerpatients. Citation: Mazzone PJ, Marchi N, Faz