副肿瘤性神经系统综合征的临床分型、相关肿瘤及免疫学研究  

An immunological study of paraneoplastic neurological syndromes associated with malignant tumors and clinical types

作　　者：陈齐鸣[1] 钱伟东[1] 宋文英[1] 李强[1] 刘晓林[1] 屈洪党[1] 韦道祥[1] JeanYves Delattre Francesc Graus 

机构地区：[1]蚌埠医学院附属医院神经内科,安徽蚌埠233004 [2]法国巴黎彼尔.玛丽.居里大学Salpetriere医学院Salpetriere医院神经内科,75651 [3]西班牙巴塞罗那Provincial Clinici医院神经内科

出　　处：《蚌埠医学院学报》2004年第5期377-379,390,共4页Journal of Bengbu Medical College

基　　金：安徽省自然科学基金资助项目 (编号 0 3 0 43 715 ) ;安徽省教育厅资助项目 (编号JL164 )

摘　　要：目的 :将 4 30例副肿瘤性神经系统综合征 (PNS)临床分型、相关癌肿及免疫学进行一次对照研究。方法 :采用亲合免疫细胞组织化学和免疫印迹技术测定 4 30例PNS患者血清及脑脊液中的特异性神经元抗体。结果 :4 30例PNS患者的临床表现类型主要有副肿瘤性感觉神经元病、副肿瘤性脑脊髓炎、副肿瘤性小脑变性、副肿瘤性边缘叶脑炎及副肿瘤性眼阵挛 -肌阵挛综合征 ,相关肿瘤主要见于小细胞肺癌、乳腺癌、卵巢癌、霍奇金淋巴瘤等 ,其中 2 81例患者血清中存在特异性神经元抗体。结论 :因PNS患者体内存在多种自身特异性神经元抗体 ,提示PNS是一种癌肿导致的自身免疫性疾病 。Objective:To study the relationship of paraneoplastic neurological syndromes(PNS) with malignant tumors and clinical types.Methods:Immunohistochemistry(ABC method) and Western blot analysis were used to detect specific neuronal antibodies in 430 PNS patients with malignant tumors.Results:Clinical types of 430 PNS patients include paraneoplastic sensory neuronopathy,paraneoplastic encephalomyelitis,paraneoplastic cerebellar degeneration,paraneoplastic limbic encephalitis and paraneoplastic opsoclonus myoclonus,PNS may complicate any malignant tumor but is more common with small cell lung cancer,breast cancer,ovarian cancer and Hodgkin's lymphoma.The high titer specific neuronal antibodies have been confirmed in the serum and cerebrospinal fluid of 281 patients.Conclusions:Various specific neuronal antibodies found in PNS patients strongly demonstrate that PNS is autoimmune disorders of nervous system resulting from malignant tumor,and detection of these specific neuronal antibodies is favorable for early diagnoses of PNS and associated malignant tumors.

关 键 词：副肿瘤性神经系统综合征 肿瘤 抗体 免疫 

分 类 号：R73[医药卫生—肿瘤]