Lennon V A, Sas D F, Busk M F, Scheithauer B, Malagelada J R, Camilleri M, Miller L J
Gastroenterology Research Unit, Mayo Clinic and Foundation, Rochester, Minnesota.
Gastroenterology. 1991 Jan;100(1):137-42. doi: 10.1016/0016-5085(91)90593-a.
Severe gastrointestinal dysmotility is a newly recognized paraneoplastic syndrome that occurs with small-cell lung carcinoma. Thirty-four patients with small-cell carcinoma, of whom 5 had chronic intestinal pseudoobstruction and 29 had no digestive symptoms, were studied serologically. Four of the 5 patients with gut dysmotility had immunoglobulin G antibodies reactive with neurons of the myenteric and submucosal plexuses of jejunum and stomach in an indirect immunofluorescence assay. Antibodies of this type were not found in any of the 29 patients who had no gut dysmotility, nor were they found in patients with chronic idiopathic intestinal pseudoobstruction (n = 8), ovarian cancer (n = 20), or epilepsy (n = 4) or in normal subjects (n = 9). In 4 of the patients with paraneoplastic pseudoobstruction, antibodies in highly diluted serum (1:4000-1:8000) bound selectively to nuclei and cytoplasm of neuronal elements in the gut. This novel autoantibody activity suggests that intestinal pseudoobstruction occurring in patients with small-cell carcinoma may have an autoimmune basis. From a clinical standpoint, serological testing offers a simple means for determining which patients with gut dysmotility syndromes may have associated small-cell carcinoma, thereby enabling earlier diagnosis and treatment of the tumor.
严重胃肠动力障碍是一种新认识的副肿瘤综合征，与小细胞肺癌相关。对34例小细胞癌患者进行了血清学研究，其中5例有慢性肠道假性梗阻，29例无消化症状。在间接免疫荧光试验中，5例肠道动力障碍患者中有4例的免疫球蛋白G抗体与空肠和胃的肌间神经丛及黏膜下神经丛的神经元发生反应。在29例无肠道动力障碍的患者中均未发现此类抗体，在慢性特发性肠道假性梗阻患者（n = 8）、卵巢癌患者（n = 20）、癫痫患者（n = 4）或正常受试者（n = 9）中也未发现。在4例副肿瘤性假性梗阻患者中，高度稀释血清（1:4000 - 1:8000）中的抗体选择性地与肠道神经元成分的细胞核和细胞质结合。这种新的自身抗体活性表明，小细胞癌患者发生的肠道假性梗阻可能有自身免疫基础。从临床角度看，血清学检测为确定哪些肠道动力障碍综合征患者可能伴有小细胞癌提供了一种简单方法，从而能够更早地诊断和治疗肿瘤。
