Department of Neurology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
Department of Neurology, Groene Hart Hospital, Gouda, The Netherlands.
Sci Rep. 2020 Jun 29;10(1):10546. doi: 10.1038/s41598-020-67571-9.
To evaluate the Dutch-English Lambert-Eaton Myasthenic Syndrome (LEMS) Tumour Association Prediction (DELTA-P) score in a prospective cohort of patients with newly diagnosed LEMS to assess the clinical validity of this tool in a real-world setting. Clinical features from 87 patients with LEMS, occurring within three months from disease onset, were collated to produce a DELTA-P score for each patient. Lung cancer was detected in 44/87 (51%) LEMS patients. Weight loss ≥ 5%, tobacco use at LEMS onset and age at onset ≥ 50 years were independent predictors for the development of small-cell lung cancer (SCLC) in LEMS patients in multivariable analysis. Median DELTA-P scores were significantly higher in SCLC-LEMS patients (3.5, 95% CI 3 to 4) compared to non-tumour-LEMS (2, 95% CI 1 to 2) (P < 0.0001). Higher DELTA-P scores increased the risk of SCLC stepwise (score 0 = 0%, 1 = 18.8%, 2 = 45%, 3 = 55.5%, 4 = 85.7%, 5 = 87.5%, 6 = 100%). The area under the curve of the receiver operating curve was 82.5% (95% CI 73.9% to 91%). The DELTA-P cancer prediction score, calculated at the time of LEMS diagnosis, is an effective tool for cancer screening in an independent, prospective study setting.
评估荷兰语-英语 Lambert-Eaton 肌无力综合征 (LEMS) 肿瘤协会预测 (DELTA-P) 评分在新诊断的 LEMS 患者前瞻性队列中的临床有效性，以评估该工具在真实环境中的临床有效性。收集了 87 例 LEMS 患者的临床特征，这些患者在疾病发病后三个月内发病，为每位患者生成一个 DELTA-P 评分。87 例 LEMS 患者中有 44 例（51%）发现肺癌。多变量分析显示，体重减轻≥5%、LEMS 发病时吸烟和发病年龄≥50 岁是 LEMS 患者发生小细胞肺癌 (SCLC) 的独立预测因素。在 SCLC-LEMS 患者中，中位数 DELTA-P 评分明显高于非肿瘤-LEMS 患者（3.5，95%CI 3 至 4）（P<0.0001）。较高的 DELTA-P 评分逐步增加 SCLC 的风险（评分 0=0%，1=18.8%，2=45%，3=55.5%，4=85.7%，5=87.5%，6=100%）。接受者操作特征曲线下的面积为 82.5%（95%CI 73.9%至 91%）。在 LEMS 诊断时计算的 DELTA-P 癌症预测评分是一种在独立、前瞻性研究环境中进行癌症筛查的有效工具。
