Verschuuren J J, Perquin M, ten Velde G, De Baets M, Vriesman P B, Twijnstra A
Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
J Neurol Neurosurg Psychiatry. 1999 Sep;67(3):353-7. doi: 10.1136/jnnp.67.3.353.
To follow up the level of anti-Hu antibody titres during chemotherapy and to compare the pattern of metastases and other neurological complications before and after chemotherapy in patients with small cell lung cancer (SCLC) with and without low titre anti-Hu antibodies. Seventeen per cent of patients with SCLC without paraneoplastic syndromes have a low titre of anti-Hu antibodies in their serum. Previous studies suggested that these antibodies correlate with a more indolent tumour growth.
The serum of 52 consecutive patients with SCLC were studied before and during chemotherapy, and the correlation with stage of disease and pattern of metastases was examined. All serum samples were investigated using western blot and enzyme linked immunosorbent assay (ELISA) with HuD recombinant protein. All patients with SCLC were investigated using MRI of the brain, CSF, bone marrow aspiration, ultrasound of the abdomen, and radionuclide bone scan.
Nine (17%) of 52 SCLC serum samples were positive by western blot. At the time of diagnosis none of the anti-Hu positive patients had either CNS (brain or leptomeningeal), epidural, adrenal, or bone marrow metastases and 56% had limited disease. In eight of 43 anti-Hu negative patients CNS metastases were found at the time of diagnosis, and only 30% had limited disease. The prevalence of bone and liver metastases was similar in both groups. Survival was 11 (SD ) months for the 43 anti-Hu negative and 10 (SD 6) months for the nine anti-Hu positive patients. Male:female ratio in the anti-Hu negative group was 4.4:1, and in the anti-Hu positive group 2:1.
No anti-Hu antibody positive serum, as tested by western blot, became negative during chemotherapy. Anti-Hu positive and anti-Hu negative patients had similar survival, but anti-Hu positive patients tended to be women, had limited disease at the time of tumour diagnosis, and initially metastases seemed to spare the nervous system.
随访化疗期间抗Hu抗体滴度水平，并比较伴有和不伴有低滴度抗Hu抗体的小细胞肺癌（SCLC）患者化疗前后转移模式及其他神经并发症情况。17%无副肿瘤综合征的SCLC患者血清中有低滴度抗Hu抗体。既往研究表明，这些抗体与肿瘤生长较为惰性相关。
对52例连续的SCLC患者化疗前及化疗期间的血清进行研究，并检测其与疾病分期及转移模式的相关性。所有血清样本均采用免疫印迹法及用HuD重组蛋白的酶联免疫吸附测定（ELISA）法进行检测。所有SCLC患者均接受脑部MRI、脑脊液检查、骨髓穿刺、腹部超声及放射性核素骨扫描检查。
52份SCLC血清样本中有9份（17%）免疫印迹法检测呈阳性。诊断时，抗Hu阳性患者均无中枢神经系统（脑或软脑膜）、硬膜外、肾上腺或骨髓转移，56%为局限性疾病。43例抗Hu阴性患者中有8例诊断时发现有中枢神经系统转移，仅30%为局限性疾病。两组骨转移和肝转移的发生率相似。43例抗Hu阴性患者的生存期为11（标准差）个月，9例抗Hu阳性患者为10（标准差6）个月。抗Hu阴性组男女比例为4.4:1，抗Hu阳性组为2:1。
经免疫印迹法检测，化疗期间无抗Hu抗体阳性血清转为阴性。抗Hu阳性和抗Hu阴性患者生存期相似，但抗Hu阳性患者多为女性，肿瘤诊断时为局限性疾病，且最初转移似乎未累及神经系统。
