Tumor diagnostic rate and tumor marker determination for 84 patients with typical paraneoplastic antibody positive

doi:10.3969/j.issn.1673-8640.2018.08.008

Abstract

Abstract:

Objective To investigate the cause for low tumor diagnostic rate for patients with typical paraneoplastic antibody positive.Methods Neuronal antigen IgG antibody was determined by immunoblotting assay. Tumor markers were determined by chemiluminescence. The clinical data,including the results of tumor biomarkers and diagnosis for patients with typical paraneoplastic antibody positive,were collected through terminal electronic medical record.Results There were 15（17.9%）,0（0.0%）,18（21.4%）,26（31.0%）,9（10.7%） and 12（14.3%） positive cases of anti-Hu,anti-Ri,anti-Yo,anti-PNMA2（Ma2/Ta）,anti-CV2 and anti-Amphiphysin antibodies,respectively. There were 3 positive cases of both anti-CV2 and anti-PNMA2（Ma2/Ta） antibodies and 1 positive case of both anti-CV2 and anti-Hu antibodies. Tumors were found in 14.3% patients of 84 cases of typical paraneoplastic antibody positive. Moreover,7.4% patients with positive anti-Hu or anti-Amphiphysin antibodies were diagnosed with tumors. Tumor markers were not determined in 14 of 72 patients（19.4%） who were not diagnosed with tumors. The negative rate and the positive rate of tumor markers were 46.6%（27 cases） and 53.4%（31 cases） in 58 patients who were not diagnosed with tumors,respectively.Conclusions The tumor missed diagnosis rate is high in patients with typical paraneoplastic antibody positive,which could be due to the missed determination of tumor markers,no further determination of tumors in patients with normal tumor marker determination results and inaccurate site of tumor examination.

Key words: Typical paraneoplastic antibody, Neuronal antigen antibody, Tumor marker, Paraneoplastic syndrome

CLC Number:

R446.1

LIU Xia, WU Yanyan, WANG Jinling, LAN He, LIU Li, WANG Peichang. Tumor diagnostic rate and tumor marker determination for 84 patients with typical paraneoplastic antibody positive[J]. Laboratory Medicine, 2018, 33(8): 702-706.

年龄组别	例数	百分率（%）
<20岁组	1	1.19^*#
20~39岁组	7	8.33^*#
40~55岁组	28	33.33
>55岁组	48	57.14^*

年龄组别	例数	百分率（%）
<20岁组	1	1.19^*#
20~39岁组	7	8.33^*#
40~55岁组	28	33.33
>55岁组	48	57.14^*

典型副肿瘤抗体	阳性例数	诊断肿瘤例数 [例（%）]	肿瘤名称和例数	未诊断肿瘤例数 [例（%）]
抗Amphiphysin抗体	12	1（8.33）	乳腺癌1例	11（91.67）
抗CV2抗体	9	2（22.22）	胸腺瘤2例	7（77.78）
抗PNMA2（Ma2/Ta）抗体	26	2（7.69）	子宫肌瘤2例、乳腺癌1例、肺部肿瘤1例	24（92.31）
抗Ri抗体	0
抗Yo抗体	18	4（22.22）	肺癌、乳腺癌、卵巢癌、肿瘤脑转移各1例	14（77.78）
抗Hu抗体	15	1（6.67）	子宫肌瘤	14（93.33）
抗CV2+抗Ma2	3	2（66.67）	乳腺癌2例	1（33.33）
抗CV2+抗Hu	1	0（0）		1（100.00）
合计	84	12（14.29）		72（85.71）

典型副肿瘤抗体	阳性例数	诊断肿瘤例数 [例（%）]	肿瘤名称和例数	未诊断肿瘤例数 [例（%）]
抗Amphiphysin抗体	12	1（8.33）	乳腺癌1例	11（91.67）
抗CV2抗体	9	2（22.22）	胸腺瘤2例	7（77.78）
抗PNMA2（Ma2/Ta）抗体	26	2（7.69）	子宫肌瘤2例、乳腺癌1例、肺部肿瘤1例	24（92.31）
抗Ri抗体	0
抗Yo抗体	18	4（22.22）	肺癌、乳腺癌、卵巢癌、肿瘤脑转移各1例	14（77.78）
抗Hu抗体	15	1（6.67）	子宫肌瘤	14（93.33）
抗CV2+抗Ma2	3	2（66.67）	乳腺癌2例	1（33.33）
抗CV2+抗Hu	1	0（0）		1（100.00）
合计	84	12（14.29）		72（85.71）

抗体名称	阳性例数	未诊断肿瘤例数	肿瘤标志物未检测例数	肿瘤标志物检测例数	肿瘤标志物结果正常例数	肿瘤标志物结果异常例数
抗Amphiphysin抗体	12	11	2	9	6	3（CA72-4、NSE、CYFRA21-1各有 1例升高）
抗CV2抗体	9	7	3	4	0	4（CA72-4、NSE、PSA、 CYFRA21-1各有1例升高）
抗PNMA2 （Ma2/Ta）抗体	26	24	2	22	9	13（CYFRA21-1、NSE、CA19-9、 CA72-4、CEA、PSA例数分别为 9、9、1、2、1和3例）
抗Ri抗体	0	0
抗Yo抗体	18	14	2	12	8	4（CYFRA21-1升高2例、CA72-4升高 3例）
抗Hu抗体	15	14	5	9	3	6（CYFRA21-1、NSE、CA19-9、 CA72-4、CEA、PSA升高例数分别为1、1、1、2、1、3例）
抗CV2+抗Ma2	3	1	0	1	0	1例CYFRA21-1升高
抗CV2+抗Hu	1	1	0	1	1	0例
合计	84	72	14	58	27	31

Tumor diagnostic rate and tumor marker determination for 84 patients with typical paraneoplastic antibody positive

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抗体名称	阳性例数	终末诊断
抗Amphiphysin抗体	12	脑血管病、周围神经病、共济失调、脊髓病
抗CV2抗体	9	颅内病变、周围神经病、脑炎、肌无力、脱髓鞘病、脊髓炎、痴呆
抗PNMA2（Ma2/Ta）抗体	26	癫痫、脑白质病、颅内压增高、神经变性病、复视、痴呆、急性脑血管病、脑炎、肌无力、周围神经病、亚急性联合病变、帕金森病、痴呆
抗Yo抗体	18	肌无力、颅内病变、脊髓病、周围神经病、脑梗死、共济失调、帕金森病、认知障碍、脱髓鞘
抗Hu抗体	15	多系统萎缩、周围神经病、脑血管脑炎、颅内病变、腰椎管狭窄、癫痫、肌无力、共济失调
抗CV2+抗Ma2	3	颅内病变、脑炎、周围神经病
抗CV2+抗Hu	1	周围神经病

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