Serum Alkaline Phosphatase in Cryptogenic Stroke Cases with Active Cancer

Area of Science:

• Biochemistry
• Oncology
• Neurology

Background:

• Cryptogenic stroke presents a diagnostic challenge, with underlying causes often remaining unclear.
• Serum alkaline phosphatase (ALP) is an enzyme commonly elevated in conditions like biliary obstruction and bone metastasis.
• The association between elevated ALP and active cancer in cryptogenic stroke patients requires further investigation.

Purpose of the Study:

• To investigate the relationship between serum alkaline phosphatase levels and the presence of active cancer in patients diagnosed with cryptogenic stroke.
• To determine if elevated serum alkaline phosphatase is an independent predictor of active cancer in this patient cohort.

Main Methods:

• Serum alkaline phosphatase levels were measured in 249 patients with cryptogenic stroke upon admission.
• Active cancer was defined as a new diagnosis, treatment, progression, or recurrence within six months prior to admission, or the presence of metastatic cancer.
• Multivariate logistic regression analyses were employed to assess the association between serum alkaline phosphatase and active cancer, adjusting for relevant covariates.

Main Results:

• Of the 249 patients, 64 were diagnosed with active cancer.
• Patients with cryptogenic stroke and active cancer exhibited significantly higher serum alkaline phosphatase levels (486±497 U/L) compared to those without cancer (259±88.2 U/L; p<0.001).
• Serum alkaline phosphatase levels ≥286 U/L were independently associated with active cancer in cryptogenic stroke patients (odds ratio [OR], 2.669; 95% confidence interval [CI], 1.291-5.517; p=0.008).

Conclusions:

• Elevated serum alkaline phosphatase levels may serve as a potential indicator of active cancer in patients presenting with cryptogenic stroke.
• This finding highlights the importance of considering underlying malignancy in the etiological workup of cryptogenic stroke, particularly in the presence of high ALP levels.
• Further research is warranted to confirm these findings and explore the clinical utility of serum alkaline phosphatase in managing cryptogenic stroke patients.