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实体瘤患者中的自身免疫现象。

Autoimmune Phenomena in Patients with Solid Tumors.

作者信息

Nenova Ivanka S, Valcheva Mariana Y, Beleva Elina A, Tumbeva Dora Y, Yaneva Marianna P, Rancheva Emilia L, Grudeva-Popova Zhanet G

机构信息

Department of Clinical Oncology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria

Department of Accounting, Finance and Statistics, Agricultural University, Plovdiv, Bulgaria

出版信息

Folia Med (Plovdiv). 2016 Sep 1;58(3):195-199. doi: 10.1515/folmed-2016-0026.

Abstract

INTRODUCTION

Autoimmune disorders have been documented in solid tumors and malignant hematological disorders. They are very common and well studied in lymphomas which are associated with immune imbalance. They are less common in solid tumors and are categorized as paraneoplastic syndromes with unclear pathogenesis.

AIM

The aim of the present study was to find the frequency of autoimmune phenomena in solid tumors of various origin, location and status of the tumor.

PATIENTS AND METHODS

Between 2000 and 2014 we studied 1083 patients with solid tumors that were diagnosed and treated in St George University Hospital, Plovdiv.

RESULTS

We found higher incidence of these phenomena in prostate and ovarian carcinomas (9.01% and 5.6%, respectively) than in other solid tumors. Their distribution by type of autoimmune disease showed that vasculitis, polyneuritis and autoimmune hemolytic anemia have the highest frequency of all. Immune thrombocytopenia, seronegative arthritis, psoriasis, polymyositis are less commonly documented. The autoimmune paraneoplastic phenomena manifest themselves metachronously, less commonly synchronously, with the tumor. In most cases, their clinical manifestation is a progressive disease or metastatic malignant disorder which respond favourably to therapy.

CONCLUSION

Paraneoplastic autoimmune phenomena are found very commonly in prostate and ovarian carcinomas. They occur in the course of the evolvement of neoplasm and can regress with medicamentous or surgical treatment of the malignoma.

摘要

引言

自身免疫性疾病已在实体瘤和恶性血液系统疾病中得到记载。它们在与免疫失衡相关的淋巴瘤中非常常见且研究充分。在实体瘤中则较少见,被归类为发病机制不明的副肿瘤综合征。

目的

本研究的目的是确定各种起源、部位和肿瘤状态的实体瘤中自身免疫现象的发生率。

患者与方法

2000年至2014年间,我们研究了在普罗夫迪夫的圣乔治大学医院诊断和治疗的1083例实体瘤患者。

结果

我们发现这些现象在前列腺癌和卵巢癌中的发生率较高(分别为9.01%和5.6%),高于其他实体瘤。按自身免疫性疾病类型分布显示,血管炎、多发性神经炎和自身免疫性溶血性贫血的发生率最高。免疫性血小板减少症、血清阴性关节炎、银屑病、多发性肌炎的记载较少。自身免疫性副肿瘤现象与肿瘤异时出现,同时出现的情况较少。在大多数情况下,其临床表现为进展性疾病或转移性恶性疾病,对治疗反应良好。

结论

副肿瘤性自身免疫现象在前列腺癌和卵巢癌中非常常见。它们在肿瘤演变过程中出现,可随着恶性肿瘤的药物或手术治疗而消退。

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