Barahman Maedeh, Shamsaei Gholamreza, Kashipazha Davood, Bahadoram Mohammad, Akade Esma'il
Department of Radiation Oncology, Firoozgar Hospital, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences (IUMS), Tehran, Iran.
Department of Neurology, School of Medicine, Musculoskeletal Rehabilitation Research Center, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Postep Psychiatr Neurol. 2024 Jun;33(2):80-92. doi: 10.5114/ppn.2024.141157. Epub 2024 Jul 11.
This article reviews the relevant literature on paraneoplastic neurological syndromes of small cell lung cancer and discusses the clinical presentation, pathophysiology, and diagnosis of these syndromes. It also includes a summary of the current treatment options for the management of them.
Paraneoplastic syndromes are a group of signs and symptoms that develop due to cancer in a remote site, mainly triggered by an autoantibody produced by the tissues involved or lymphocytes during anti-cancer defense. Among the cancers associated with paraneoplastic syndromes, lung cancers are the most common type, with small cell lung cancer being the most common subtype. The most common antibody associated with paraneoplastic syndromes is anti-Hu. Neurological and neuroendocrine syndromes comprise the majority of small cell lung cancer-related paraneoplastic syndromes. Classical paraneoplastic neurological syndromes include inappropriate antidiuretic hormone secretion, Cushing's syndrome, myasthenia gravis, Lambert-Eaton myasthenic syndrome, limbic encephalitis, paraneoplastic cerebellar degeneration, opsoclonus myoclonus ataxia, sensory neuropathy, and chorea.
Antibodies mediate paraneoplastic syndromes, and antibody detection is a crucial part of diagnosing these entities. Managing the underlying tumor is the best treatment approach for most paraneoplastic syndromes. Therefore, early diagnosis of small cell lung cancer may significantly improve the prognosis of paraneoplastic syndromes associated with it.
本文回顾了小细胞肺癌副肿瘤性神经系统综合征的相关文献,并讨论了这些综合征的临床表现、病理生理学及诊断。文中还总结了目前针对这些综合征的治疗方案。
副肿瘤综合征是一组因远处部位的癌症而出现的体征和症状,主要由抗癌防御过程中受累组织或淋巴细胞产生的自身抗体引发。在与副肿瘤综合征相关的癌症中,肺癌最为常见,其中小细胞肺癌是最常见的亚型。与副肿瘤综合征相关的最常见抗体是抗Hu抗体。神经和神经内分泌综合征构成了大多数与小细胞肺癌相关的副肿瘤综合征。典型的副肿瘤性神经系统综合征包括抗利尿激素分泌不当、库欣综合征、重症肌无力、兰伯特-伊顿肌无力综合征、边缘叶脑炎、副肿瘤性小脑变性、眼阵挛性肌阵挛性共济失调、感觉神经病和舞蹈病。
抗体介导副肿瘤综合征,抗体检测是诊断这些疾病的关键部分。对大多数副肿瘤综合征而言,治疗基础肿瘤是最佳治疗方法。因此,早期诊断小细胞肺癌可能显著改善与之相关的副肿瘤综合征的预后。