Gao Caiyun, Chen Zhongyun, Huang Huijin, Zhu Runxiu, Su Yingying
Department of Neurology, People's Hospital of Inner Mongolia Autonomous Region, Hohhot, China.
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2023 Jul 17;14:1201324. doi: 10.3389/fneur.2023.1201324. eCollection 2023.
This study aimed to analyze the severity of the condition and prognosis of patients with anti-gamma-aminobutyric-acid type B receptor (anti-GABAR) encephalitis with tumors.
Patients with anti-GABAR encephalitis admitted to one of two hospitals from 2020 to 2022 were enrolled and divided into tumor and non-tumor groups. The clinical characteristics, condition severity, treatment options, and prognosis of the two groups of patients were compared and analyzed.
Eighteen patients with anti-GABAR encephalitis were included, ten of whom had tumors. The comparison of clinical characteristics showed that rates of status epilepticus and coma were significantly higher in the group with tumors ( = 0.013 and = 0.025, respectively); the incidences of pulmonary infection, respiratory failure, hyponatremia, and hypoproteinemia were also substantially more frequent in the tumor group ( = 0.054, = 0.036, = 0.015, and = 0.025, respectively). The laboratory test result comparison showed that serum neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA) were present only in the group with tumors ( = 0.036 and = 0.092, respectively), but there was no significant difference in the occurrence of elevated CEA between the two groups. Conversely, the percentage of serum systemic autoimmune antibodies was higher in the group without tumors than in the group with tumors ( = 0.043). Patients with tumors tended to have poor outcomes ( = 0.152, OR: 7.000).
Severe brain damage and complications occur in patients with anti-GABAR encephalitis and comorbid tumors. Early screening for serum NSE and CEA helps in the early diagnosis and treatment of tumors. The prognosis is much worse for anti-GABAR encephalitis with tumors.
本研究旨在分析合并肿瘤的抗γ-氨基丁酸B型受体（抗GABABR）脑炎患者的病情严重程度及预后。
选取2020年至2022年在两家医院之一住院的抗GABABR脑炎患者，分为肿瘤组和非肿瘤组。比较分析两组患者的临床特征、病情严重程度、治疗方案及预后。
纳入18例抗GABABR脑炎患者，其中10例合并肿瘤。临床特征比较显示，肿瘤组癫痫持续状态和昏迷发生率显著更高（分别为P = 0.013和P = 0.025）；肿瘤组肺部感染、呼吸衰竭、低钠血症和低蛋白血症的发生率也明显更高（分别为P = 0.054、P = 0.036、P = 0.015和P = 0.025）。实验室检查结果比较显示，血清神经元特异性烯醇化酶（NSE）和癌胚抗原（CEA）仅在肿瘤组出现（分别为P = 0.036和P = 0.092），但两组CEA升高的发生率无显著差异。相反，非肿瘤组血清系统性自身抗体百分比高于肿瘤组（P = 0.043）。合并肿瘤的患者预后往往较差（P = 0.152，OR：7.000）。
合并肿瘤的抗GABABR脑炎患者会出现严重脑损伤和并发症。早期筛查血清NSE和CEA有助于肿瘤的早期诊断和治疗。合并肿瘤的抗GABABR脑炎患者预后更差。
