Sutton I J, Fursdon Davis C J, Esiri M M, Hughes S, Amyes E R, Vincent A
Department of Neurology, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Ann Neurol. 2001 Feb;49(2):253-7. doi: 10.1002/1531-8249(20010201)49:2<253::aid-ana47>3.0.co;2-3.
Serum antibodies to the Yo antigen are usually associated with paraneoplastic cerebellar degeneration arising in female patients with gynecological or breast malignancy and are rarely associated with other tumors. We report a male patient who presented with paraneoplastic cerebellar degeneration and anti-Yo antibodies following removal of an esophageal adenocarcinoma. This is only the third report of anti-Yo antibodies occurring in a male patient. The Yo antigen was expressed by the esophageal tumor but not in a frontal lobe cerebral metastasis identified at postmortem. Interestingly, CD8+ T-cell infiltration was also found in the tumor, but not in the metastasis, consistent with down-regulation of Yo expression by the tumor cells leading to evasion from immune-mediated tumor surveillance.
抗Yo抗原的血清抗体通常与妇科或乳腺恶性肿瘤女性患者发生的副肿瘤性小脑变性相关,很少与其他肿瘤相关。我们报告了一名男性患者,在切除食管腺癌后出现了副肿瘤性小脑变性和抗Yo抗体。这是抗Yo抗体在男性患者中出现的第三例报告。食管肿瘤表达Yo抗原,但在尸检时发现的额叶脑转移瘤中不表达。有趣的是,肿瘤中也发现了CD8 + T细胞浸润,但转移瘤中未发现,这与肿瘤细胞下调Yo表达导致逃避免疫介导的肿瘤监视一致。