Elrington G M, Murray N M, Spiro S G, Newsom-Davis J
National Hospital, London, UK.
J Neurol Neurosurg Psychiatry. 1991 Sep;54(9):764-7. doi: 10.1136/jnnp.54.9.764.
One hundred and fifty patients presenting with small cell lung cancer (SCLC) to chest physicians, were assessed neurologically. Neuromuscular or autonomic deficits were common and occurred in up to 44% of cases. Weakness, dry mouth, and weight loss were not mutually independent and may represent the syndrome formerly described as carcinomatous neuromyopathy. By contrast, undoubted paraneoplastic syndromes were much less commonly detected. Two patients had the Lambert-Eaton myasthenic syndrome (LEMS) and one had subacute sensory neuropathy (SSN). In these patients, neurological symptoms antedated other manifestations of cancer, by between six and 17 months. The 95% confidence interval for the prevalence of LEMS or SSN among SCLC patients was 0-4%, consistent with the results of previous retrospective or smaller studies: summing these, the overall prevalence of LEMS among SCLC patients is close to 3%, which implies about 250 new cases per annum in England and Wales. If LEMS and SSN are the least uncommon neurological paraneoplastic syndromes in SCLC patients, this may reflect the accessibility of motor nerve terminals and dorsal root ganglia to cross-reactive anti-tumour cell antibodies.
150名因小细胞肺癌（SCLC）就诊于胸科医生的患者接受了神经学评估。神经肌肉或自主神经功能障碍很常见，高达44%的病例出现此类情况。虚弱、口干和体重减轻并非相互独立，可能代表以前描述的癌性神经肌病综合征。相比之下，明确的副肿瘤综合征则很少被检测到。两名患者患有兰伯特-伊顿肌无力综合征（LEMS），一名患者患有亚急性感觉神经病（SSN）。在这些患者中，神经症状比癌症的其他表现提前6至17个月出现。SCLC患者中LEMS或SSN患病率的95%置信区间为0-4%，与之前的回顾性研究或规模较小的研究结果一致：综合这些研究，SCLC患者中LEMS的总体患病率接近3%，这意味着在英格兰和威尔士每年约有250例新病例。如果LEMS和SSN是SCLC患者中最常见的神经副肿瘤综合征，这可能反映了运动神经末梢和背根神经节对交叉反应性抗肿瘤细胞抗体的易感性。
