939例副肿瘤综合征相关抗体11项血清检测结果分析

Analysis of 939 patients′11 serum test results of antibodies related to paraneoplastic syndrome

目的分析副肿瘤综合征相关抗体11项血清检测结果与神经系统疾病的相关性。方法采用免疫印迹法检测患者血清中的抗Hu抗体、抗Yo抗体、抗Ri抗体、抗CV2(CRMP5)抗体、抗Amphiphysin抗体、抗Ma1抗体、抗Ma2抗体、抗SOX1抗体、抗Tr(DNER)抗体和抗Zic4抗体、抗GAD65抗体。结果(1)939例患者总体阳性率为7.77%,脑炎、头痛头晕、癫痫、麻木、脊髓炎、肿瘤、脱髓鞘病变、记忆力下降、呼吸衰竭和前庭综合征阳性率均高于总体阳性率。男41例(7.81%),女32例(7.73%),男女阳性比较差异无统计学意义(P>0.05)。头痛头晕组女阳性率17.14%>男阳性率2.27%;麻木组男阳性率12.90%>女阳性率00.00%,两组男女阳性比较差异有统计学意义(P<0.01)。脑炎组女阳性率12.15%>男阳性率4.24%;周围神经病组男阳性率7.02%>女阳性率00.00%,两组男女阳性比较差异有统计学意义(P<0.05)。癫痫、脑梗死、颅内病变、认知障碍、脊髓炎、肿瘤组,男女阳性差异无统计学意义(P>0.05)。其余组数据太少不做比较。(2)73例副肿瘤综合征相关抗体阳性者年龄分布,<20岁组仅6例(8.22%),20~39岁组共8例(10.96%),40~55岁组占14例(19.18%),>55岁组45例(61.64%),不同年龄组副肿瘤综合征阳性率随年龄升高而升高,>55岁组为高危发病年龄区间。(3)在73例副肿瘤综合征相关抗体阳性者中,抗Yo抗体占比最高31.51%,其次是抗CV2抗体21.92%和SOX1为20.55%。在20种临床诊断或表现中抗Yo抗体和抗CV2抗体在13种疾病中检测出阳性;抗Hu抗体出现在7种疾病中检测出阳性;抗SOX1抗体在6种疾病中检测出阳性;抗GAD65抗体在6种疾病中检测出阳性;抗Ma2抗体和抗Amphiphysin抗体在3种疾病中检测出阳性;抗Ri抗体、抗Ma1抗体、抗Tr抗体和抗Zic4抗体只在其中1种疾病中检测出阳性。73例阳性患者中有12例患者2种及以上抗体阳性13例占比17.81%。结论PNS临床表现形式多样,自身免疫是其可能发病机制,副肿瘤综合征相关抗体检测可为早期诊断鉴别及早发现潜在的肿瘤,提供依据。

Objective To analyze the correlation between 11 serum test results of antibodies related to paraneoplastic syndrome and neurological diseases.Methods Anti-Hu antibody,anti-Yo antibody,anti-Ri antibody,anti-CV2(CRMP5)antibody,anti-Amphiphysin antibody,anti-Ma1 antibody,anti-Ma2 antibody,anti-SOX1 antibody,anti-Tr(DNER)Antibodies and anti-Zic4 antibodie sand anti-GAD65 antibodies were detected with Immunoblotting.Results(1)The overall positive rate of 939 patients was 7.77%.The positive rates of patients with encephalitis,headache,dizziness,epilepsy,numbness,myelitis,tumor,demyelinating disease,memory loss,respiratory failure and vestibular syndrome were higher than the overall positive rate.There was no significant difference(P>0.05)between male group 41(7.81%)and female group 32(7.73%).In the headache dizziness group,the female positive rate(17.14%)was higher than male positive rate(2.27%).In the numb group,the male positive rate(12.90%)was higher than female positive rate(00.00%).The difference between male and female in these two groups was significant(P<0.01).The female positive rate in the encephalitis group(12.15%)was higher than the male positive rate(4.24%).The male positive rate(7.02%)was higher than the female positive rate(00.00%)in the peripheral neuropathy group.There was significant difference between the male and female groups in these two groups(P<0.05).In epilepsy,cerebral infarction,intracranial lesions,cognitive impairment,myelitis,and tumor groups,there was no statistically significant difference between male and female(P>0.05).The rest of the data was too few to compare.(2)The age distribution of 73 positive cases of paraneoplastic syndrome-related antibodies,only 6 cases(8.22%)in the<20 years old group,8 cases(10.96%)in the 20-39 years old group,14 cases in the 40-55 years old group(19.18%),and 45 cases in the>55 years old group(61.64%).The positive rate of paraneoplastic syndrome in different age groups increased with age,>55 years old group was the high-risk age range.(3)Among 73 cases of paraneoplastic syndrome related antibodies,anti-Yo antibody accounted for the highest 31.51%,followed by anti-CV2 antibody 21.92%and SOX120.55%.Anti-Yo antibody and anti-CV2 antibody were detected positive in 13 diseases in 20 clinical diagnoses or manifestations;anti-Hu antibody was detected positive in 7 diseases;anti-SOX1 antibody was detected positive in 6 diseases;GAD65 antibody was detected positive in 6 diseases;anti-Ma2 antibody and anti-Amphiphysin antibody were positive in 3 diseases;anti-Ri antibody,anti-Ma1 antibody,anti-Tr antibody and anti-Zic4 antibody were detected in only 1 disease Positive.Among the 73 positive patients,12 patients had two or more antibodies and 13 patients accounted for 17.81%.Conclusion The clinical manifestations of PNS are diverse,and autoimmunity is its possible pathogenesis.The detection of antibodies related to paraneoplastic syndrome can provide a basis for early diagnosis and early identification of potential tumors.