卵巢畸胎瘤相关抗N-甲基-D-天冬氨酸受体脑炎发病机制及诊疗研究进展

Advances in Pathogenesis,Diagnosis and Treatment of Ovarian Teratoma Associated Anti-N-methyl-D-aspartate Receptor Encephalitis

抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎是一种自身免疫性脑炎,是卵巢畸胎瘤的罕见并发症之一,主要治疗方式为手术切除肿瘤联合免疫治疗,但卵巢畸胎瘤相关抗NMDAR脑炎的发病机制目前尚不明确,且患者临床表现多样,多以神经系统表现为主,易误诊及漏诊,需妇科和神经内科医生共同诊断及治疗。本文综述了NMDAR的结构和功能,归纳了既往卵巢畸胎瘤相关抗NMDAR脑炎的相关研究成果,总结其发病机制、早期诊断、鉴别诊断、治疗、预后和复发的研究进展,为更好地诊断和治疗卵巢畸胎瘤相关抗NMDAR脑炎提供理论依据和思路。

Anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis is an autoimmune encephalitis that is a rare complication of ovarian teratoma.The primary treatment is surgical resection of the tumor combined with immunotherapy,however,the pathogenesis of ovarian teratoma associated anti-NMDAR encephalitis is still unclear.In addition,the patients present with various clinical manifestations,with neurological manifestations predominating,which is easy to be misdiagnosed and overlooked,requiring joint diagnosis and treatment by gynecologists and neurologists.This article briefly describes the structure and function of NMDAR,reviews the previous research results on ovarian teratoma associated anti-NMDAR encephalitis,and summarizes the research progress on its pathogenesis,early diagnosis,differential diagnosis,treatment,prognosis and recurrence,aiming to provide theoretical basis and ideas for better diagnosis and treatment of ovarian teratoma associated anti-NMDAR encephalitis.