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[自身免疫过程作为家族性乳腺癌的副肿瘤表现]

[Autoimmune processes as paraneoplastic manifestations in familial breast carcinoma].

作者信息

Calderoni A, Altermatt H J, Pirovino M

机构信息

Medizinische Klinik, Kantonsspitals Olten.

出版信息

Dtsch Med Wochenschr. 1994 Sep 9;119(36):1194-8. doi: 10.1055/s-2008-1058821.

Abstract

In two patients, mother and daughter, with breast cancer a paraneoplastic syndrome of probably autoimmune pathogenesis developed in the course of the neoplastic disease. In the mother the cancer occurred when she was aged 51, first in the left and then, 4 years later, in the right breast. A local recurrence 18 years later caused a pericardial effusion and further tumour recurrences were associated with symptoms like those in Sjögren's syndrome, as well as bullous pemphigoid and polyneuropathy. Antinuclear antibodies, extractable nuclear antigen antibodies and rheuma factors were demonstrated in serum. Both symptoms and antibody titres regressed under treatment with tamoxifen and various cytostatic drugs. The patient died aged 74 years.--The daughter underwent a lumpectomy for breast cancer when aged 39 years, followed by mastectomy for local recurrence after 2 years. A further 2 years later she was found to be anaemic with a positive Coombs test (1:1024) and antibodies against IgG and complement. Metastases developed later. In her case, too, clinical and serological findings clearly regressed under treatment with tamoxifen and chemotherapy. She died, aged 45 years, from the consequences of further metastases.

摘要

在两名乳腺癌患者(母亲和女儿)中,肿瘤疾病过程中出现了一种可能由自身免疫发病机制引起的副肿瘤综合征。母亲51岁时患癌,先是左侧乳房,4年后右侧乳房也出现癌症。18年后局部复发导致心包积液,进一步的肿瘤复发伴有干燥综合征、大疱性类天疱疮和多发性神经病等症状。血清中检测到抗核抗体、可提取核抗原抗体和类风湿因子。在他莫昔芬和各种细胞毒性药物治疗下,症状和抗体滴度均有所下降。患者于74岁去世。——女儿39岁时因乳腺癌接受了肿块切除术,2年后因局部复发接受了乳房切除术。又过了2年,她出现贫血,库姆斯试验呈阳性(1:1024),并检测到抗IgG和补体抗体。后来发生了转移。在她的病例中,他莫昔芬和化疗治疗下临床和血清学结果也明显好转。她45岁时因进一步转移的后果去世。

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