Department of Medical Oncology, University of Oxford Medical Oncology Unit, Oxford, United Kingdom.
J Thorac Oncol. 2010 Jan;5(1):34-8. doi: 10.1097/JTO.0b013e3181c3f4f1.
The Lambert Eaton myasthenic syndrome (LEMS) is a paraneoplastic disorder associated with raised serum voltage-gated calcium channel (VGCC) antibodies in patients with small cell lung cancer (SCLC). VGCC can also be found in patients with SCLC and cerebellar ataxia. This was a prospective study to assess the incidence of clinical and subclinical LEMS or other neurologic disease in patients with SCLC.
Sixty-three unselected patients with cytologically or histologically confirmed SCLC consented to participate. Pretreatment assessment included a neurologic symptom questionnaire, examination for physical signs of LEMS or ataxia, measurement of serum titers of antibodies to P/Q-type VGCCs by radioimmunoassay in all patients and electrophysiological examination where appropriate.
Neurologic symptoms unrelated to LEMS occurred in 26% of patients. Five patients (8%) had raised serum VGCC antibodies (range, 69-1553 pM/l) diagnostic of LEMS, two (3%) of whom had LEMS on clinical and electrophysiological grounds. Both also had mild cerebellar ataxia. There was no association between serum VGCC antibody titer and survival.
Routine measurement of VGCC antibodies in patients without clinical LEMS is unlikely to assist either in management of SCLC or in assessment of prognosis.
Lambert-Eaton 肌无力综合征（LEMS）是一种副肿瘤性疾病，与小细胞肺癌（SCLC）患者血清电压门控钙通道（VGCC）抗体升高有关。VGCC 也可在 SCLC 伴小脑共济失调患者中发现。本前瞻性研究旨在评估 SCLC 患者中临床和亚临床 LEMS 或其他神经疾病的发生率。
63 例经细胞学或组织学证实的 SCLC 患者均入选本研究。治疗前评估包括神经症状问卷、LEMS 或共济失调的体格检查、所有患者血清 P/Q 型 VGCC 抗体滴度的放射免疫测定，以及适当的电生理检查。
26%的患者出现与 LEMS 无关的神经症状。5 例（8%）患者血清 VGCC 抗体升高（范围 69-1553 pM/l），诊断为 LEMS，其中 2 例（3%）根据临床和电生理检查诊断为 LEMS。这两例患者均伴有轻度小脑共济失调。血清 VGCC 抗体滴度与生存无相关性。
在无临床 LEMS 的患者中常规测量 VGCC 抗体不太可能有助于 SCLC 的治疗或预后评估。
