Department of Neurology, Division of Neuro-Oncology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Semin Neurol. 2010 Jul;30(3):320-31. doi: 10.1055/s-0030-1255223. Epub 2010 Jun 24.
Although the discovery of antineuronal antibodies has facilitated the diagnosis of paraneoplastic neurologic disorders, the recognition and treatment of these disorders remain a challenge. Some antibodies are more syndrome-specific than others, and some syndromes suggest a paraneoplastic etiology more frequently than others. Because some antineuronal antibodies may occur in cancer patients without paraneoplastic neurologic disorders, their detection does not necessarily imply that a neurologic disorder is paraneoplastic. Moreover, there is an emerging group of encephalitides that appear to be mediated by antibodies against cell surface or synaptic proteins, may occur with or without tumor association, and are responsive to treatment. This review analyzes the immune responses associated with paraneoplastic and nonparaneoplastic disorders of the central nervous system, and the main clinical features and response to treatment.
尽管抗神经元抗体的发现有助于副肿瘤性神经疾病的诊断，但这些疾病的识别和治疗仍然是一个挑战。一些抗体比其他抗体更具综合征特异性，而一些综合征比其他综合征更频繁地提示副肿瘤性病因。由于一些抗神经元抗体可能出现在没有副肿瘤性神经疾病的癌症患者中，因此它们的检测并不一定意味着神经疾病是副肿瘤性的。此外，还有一组新兴的脑炎似乎是由针对细胞表面或突触蛋白的抗体介导的，可能与肿瘤有关或无关，并且对治疗有反应。这篇综述分析了与中枢神经系统的副肿瘤性和非副肿瘤性疾病相关的免疫反应，以及主要的临床特征和治疗反应。
