Psychological distress, cancer-associated coagulopathy, and genetic vulnerability: Integrating psycho-oncology mechanisms in ischemic stroke risk
Abstract
The relationship between Factor V gene polymorphism, immune biomarkers, and ischemic stroke (IS) remains insufficiently understood in Asian populations, and even less is known about how cancer-related physiological and psychological processes may jointly contribute to cerebrovascular vulnerability. This case–control study examined whether Factor V Leiden polymorphism, anticardiolipin antibody (ACA) levels, and cancer history were associated with IS risk in Chinese adults, while interpreting these associations through a psycho-oncological framework. Factor V genotypes were identified using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP), and ACA levels were measured using enzyme-linked immunosorbent assay (ELISA). Clinical variables, including hypertension and cancer/tumor history, were also evaluated. The GA and AA genotypes and the A allele of the Factor V gene were significantly associated with increased IS risk (P < 0.05). Hypertension and cancer/tumor occurrence were more prevalent in the IS group (P < 0.001). Although mean ACA levels did not differ between groups, cancer patients exhibited a higher likelihood of ACA positivity, consistent with immune activation in malignancy. Interpreted from a psycho-oncological perspective, cancer-related hypercoagulability may interact with chronic psychological distress characterized by sustained stress-system activation, emotional burden, and behavioral disruption to exacerbate inflammatory and coagulative instability, thereby heightening stroke susceptibility. These findings suggest that genetic predisposition, cancer-associated physiological changes, and psychological stress may collectively shape IS risk. Future research incorporating validated psychological assessments and stress-related biomarkers, alongside longitudinal follow-up, is needed to clarify the mechanistic role of psychological distress in cancer-associated stroke vulnerability.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
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