Matsubara S, Yamaji Y, Fujita T, Kanayama T, Yamadori I, Sato M, Fujita J, Shiotani T, Takahara J
First Department of Internal Medicine, Kagawa Medical School, Japan.
Lung Cancer. 1996 Jun;14(2-3):265-71. doi: 10.1016/0169-5002(96)00552-1.
Cancer-associated retinopathy (CAR) syndrome is a rare paraneoplastic neuropathy syndrome often found in patients with small cell lung cancer (SCLC). Serological studies have indicated that the process could include autoimmune reactions directing retinal antigens. Recently, the CAR antigen was identified as a photoreceptor protein, recoverin, by screening retinal proteins using the CAR patient's serum. The present case of SCLC showed rapidly deteriorated bilateral visual acuity lacking the inflammatory findings at the retina which were compatible with CAR. The immunohistochemical study revealed that the cancer cells expressed recoverin or recoverin-like immunoreactivity. This is the first observation in CAR syndrome. The presence of recoverin or recoverin-like immunoreactivity in SCLC with CAR syndrome supports the hypothesis that the cancer-retina immunologic cross-reaction contributes to visual loss in this syndrome.
癌症相关性视网膜病变（CAR）综合征是一种罕见的副肿瘤性神经病变综合征，常见于小细胞肺癌（SCLC）患者。血清学研究表明，该过程可能包括针对视网膜抗原的自身免疫反应。最近，通过使用CAR患者的血清筛选视网膜蛋白，CAR抗原被鉴定为一种光感受器蛋白——恢复蛋白。本病例中的小细胞肺癌患者双侧视力迅速恶化，视网膜缺乏与CAR相符的炎症表现。免疫组织化学研究显示，癌细胞表达恢复蛋白或恢复蛋白样免疫反应性。这是在CAR综合征中的首次观察。伴有CAR综合征的小细胞肺癌中存在恢复蛋白或恢复蛋白样免疫反应性，支持了癌症-视网膜免疫交叉反应导致该综合征视力丧失的假说。
