单中心卵巢畸胎瘤患者中合并抗N-甲基-D-天冬氨酸受体脑炎的比例调查及临床特征分析  

Proportion and clinical features of anti-N-methyl-D-aspartate receptor encephalitis in patients with ovarian teratoma in a single center

作　　者：蒋慧云[1] 黄珊瑜[1] 李小毛[1] Jiang Huiyun;Huang Shanyu;Li Xiaomao(Department of Gynecology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院妇科,广州510630

出　　处：《新医学》2021年第7期541-544,共4页Journal of New Medicine

摘　　要：目的探究卵巢畸胎瘤患者中发生抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的比例,并将合并抗NMDAR脑炎的卵巢畸胎瘤患者与未合并抗NMDAR脑炎的卵巢畸胎瘤患者的临床特征进行总结对比。方法收集卵巢畸胎瘤患者的临床资料,将其分为合并抗NMDAR脑炎组与未合并抗NMDAR脑炎组,对其临床特征进行对比分析。结果共收集到168例卵巢畸胎瘤患者,其中14例(8.3%)合并抗NMDAR脑炎;合并抗NMDAR脑炎的卵巢畸胎瘤患者年龄低于未合并抗NMDAR脑炎的卵巢畸胎瘤患者[(23.8±5.5)岁vs.(29.8±9.1)岁,P=0.016]。合并抗NMDAR脑炎的卵巢畸胎瘤患者肿瘤标志物以癌抗原125及血清铁蛋白升高为主,而未合并抗NMDAR脑炎的卵巢畸胎瘤患者肿瘤标志物以糖类抗原199升高为主。合并抗NMDAR脑炎与未合并抗NMDAR脑炎的卵巢畸胎瘤患者的肿瘤组织均可含有神经组织。结论卵巢畸胎瘤患者中发生抗NDMAR脑炎的比例不低,对于无明显症状的卵巢畸胎瘤患者,可考虑积极行手术治疗,以降低发生抗NMDAR脑炎的风险。Objective To determine the incidence of anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis in patients with ovarian teratoma and to compare the clinical characteristics between ovarian teratoma patients with and without anti-NMDAR encephalitis.Methods Clinical data of ovarian teratoma patients were collected and divided into the anti-NMDAR encephalitis group and non-anti-NMDAR encephalitis group.Clinical characteristics were statistically compared between two groups.Results Among 168 patients with ovarian teratoma,14 cases(8.3%)were complicated with anti-NMDAR encephalitis.The average age of ovarian teratoma patients complicated with anti-NMDAR encephalitis was significantly younger than that of their counterparts without anti-NMDAR encephalitis((23.8±5.5)years old vs.(29.8±9.1)years old,P=0.016).Cancer antigen 125(CA125)and serum ferritin levels were above the normal range in most ovarian teratoma patients complicated with anti-NMDAR encephalitis,and carbohydrate antigen 199(CA199)level was elevated in those without anti-NMDAR encephalitis.Pathological results revealed that nervous tissues could be detected in the tumor tissues in two groups.Conclusions The proportion of anti-NDMAR encephalitis in ovarian teratoma patients is relatively high.For ovarian teratoma patients without significant symptoms,surgery can be actively considered to reduce the risk of anti-NMDAR encephalitis.

关 键 词：卵巢畸胎瘤 抗N-甲基-D-天冬氨酸受体脑炎 神经系统副肿瘤综合征 癌抗原125 血清铁蛋白 糖类抗原199 

分 类 号：R737.31[医药卫生—肿瘤] R742.9[医药卫生—临床医学]