OMS合并神经母细胞瘤患儿血清自身免疫抗体对神经元损伤作用的相关性研究

Study on the effect of autoimmune antibody on neuronal damage in the serum of children with opsoclonus-myoclonus-ataxia syndrome and neuroblastoma

目的研究眼痉挛-肌肉痉挛-共济失调综合征(OMS)合并神经母细胞瘤(NB)患儿血清中自身免疫抗体与神经元损伤作用的相关性。方法收集我院2010年1月—2019年12月收治的OMS合并NB和单纯NB患儿共50例的病例资料,并根据有无OMS合并症情况,将40例单纯NB患儿作为对照组,将10例OMS合并NB的患儿设为研究组。ELISA法测定两组患儿在手术前后血清中自身免疫抗体浓度水平变化,分析自身免疫抗体与OMS合并NB患儿神经元损伤的相关性。结果对两组患儿中抗Hu蛋白抗体、PCA-1、PCA-2、抗谷氨酸受体δ2抗体、ANNA-2、ANNA-3和抗GlyR抗体共7种抗体进行检测。结果显示研究组7种免疫抗体浓度水平均显著高于对照组,差异具有统计学意义(P<0.05);术后两组患儿7种抗体浓度水平呈下降趋势,但仅ANNA-2术前和术后的下降程度差异具有统计学意义(P<0.05);Pearson分析发现在OMS合并NB患儿7种自身免疫抗体中PCA-1和ANNA-3与OMS神经系统评分无关,差异无统计学意义(P>0.05),其余自身免疫抗体与OMS神经系统学评分呈正相关,差异有统计学意义(P<0.05)。结论在10例OMS合并NB患儿样本中,抗Hu蛋白抗体、PCA-2、抗谷氨酸受体δ2抗体、ANNA-2、抗GlyR抗体与OMS合并NB疾病存在相关性,其抗体浓度水平可能在一定程度上反映OMS合并NB的发生、发展情况以及神经元损伤的严重程度。

Objective To explore the correlation between autoimmune antibody and neuronal damage in serum of children with opsoclonus-myoclonus-ataxia syndrome(OMS)combined with neuroblastoma(NB).Methods Clinical data of 50 NB or OMS complicated with NB children who were admitted to our hospital from January 2010 to December 2019 were collected.According to the comorbidities,40 children with simple neuroblastoma were selected as controls Group,10 children with OMS and NB were set as the study group.The ELISA method was used to determine the level of autoimmune antibody in the sera of the above two groups of children before and after operation to explore the correlation between autoimmune antibody and neuronal damage in children with OMS combined with NB.Results Seven antibodies,including anti-Hu protein antibody,PCA-1,PCA-2,anti-glutamate receptorδ2 antibody,anti-GlyR antibody,ANNA-2 and ANNA-3 in the two groups of children were tested.The results showed that the above seven antibody levels in the study group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).All 7 antibody levels showed a downward trend after operation,but only ANNA-2 level had a statistically significant difference in the degree of decline before and after operation(P<0.05).Pearson correlation analysis found that PCA-1 and ANNA-3 antibody level had no significant correlation with OMS neurological score(P>0.05),and the other antibodies were positively correlated with OMS neurological score(P<0.05).Conclusions There were correlations between anti-Hu protein antibody,PCA-2,anti-glutamate receptorδ2 antibody,ANNA-1 and disease status in the 10 OMS complicated with NB children.Antibody concentration level maybe reflect the occurrence and development of OMS complicated neuroblastoma and the severity of neuronal injury to some extent.