Paul Gozzard1, Mark Woodhall2, Caroline Chapman2, Anjan Nibber2, Patrick Waters2, Angela Vincent2, Bethan Lang2, Paul Maddison2. 1. From the Nuffield Department of Clinical Neurosciences (P.G., M.W., A.N., P.W., A.V., B.L.), University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; Division of Medical Sciences & Graduate Entry Medicine (C.C.), University of Nottingham, Royal Derby Hospital, Derby, United Kingdom; and Division of Neurology (P.M.), Queen's Medical Centre, Nottingham, United Kingdom. p.gozzard@nhs.net. 2. From the Nuffield Department of Clinical Neurosciences (P.G., M.W., A.N., P.W., A.V., B.L.), University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom; Division of Medical Sciences & Graduate Entry Medicine (C.C.), University of Nottingham, Royal Derby Hospital, Derby, United Kingdom; and Division of Neurology (P.M.), Queen's Medical Centre, Nottingham, United Kingdom.
Abstract
OBJECTIVE: To determine the frequency and range of paraneoplastic neurologic disorders (PNDs) and neuronal antibodies in small cell lung carcinoma (SCLC). METHODS: Two hundred sixty-four consecutive patients with biopsy-proven SCLC were recruited at the time of tumor diagnosis. All patients underwent full neurologic examination. Serum samples were taken prior to chemotherapy and analyzed for 15 neuronal antibodies. Thirty-eight healthy controls were analyzed in parallel. RESULTS: PNDs were quite prevalent (n = 24, 9.4%), most frequently Lambert-Eaton myasthenic syndrome (3.8%), sensory neuronopathy (1.9%), and limbic encephalitis (1.5%). Eighty-seven percent of all patients with PNDs had antibodies to SOX2 (62.5%), HuD (41.7%), or P/Q VGCC (50%), irrespective of their syndrome. Other neuronal antibodies were found at lower frequencies (GABAb receptor [12.5%] and N-type VGCC [20.8%]) or very rarely (GAD65, amphiphysin, Ri, CRMP5, Ma2, Yo, VGKC complex, CASPR2, LGI1, and NMDA receptor [all <5%]). CONCLUSIONS: The spectrum of PNDs is broader and the frequency is higher than previously appreciated, and selected antibody tests (SOX2, HuD, VGCC) can help determine the presence of an SCLC.
OBJECTIVE: To determine the frequency and range of paraneoplastic neurologic disorders (PNDs) and neuronal antibodies in small cell lung carcinoma (SCLC). METHODS: Two hundred sixty-four consecutive patients with biopsy-proven SCLC were recruited at the time of tumor diagnosis. All patients underwent full neurologic examination. Serum samples were taken prior to chemotherapy and analyzed for 15 neuronal antibodies. Thirty-eight healthy controls were analyzed in parallel. RESULTS: PNDs were quite prevalent (n = 24, 9.4%), most frequently Lambert-Eaton myasthenic syndrome (3.8%), sensory neuronopathy (1.9%), and limbic encephalitis (1.5%). Eighty-seven percent of all patients with PNDs had antibodies to SOX2 (62.5%), HuD (41.7%), or P/Q VGCC (50%), irrespective of their syndrome. Other neuronal antibodies were found at lower frequencies (GABAb receptor [12.5%] and N-type VGCC [20.8%]) or very rarely (GAD65, amphiphysin, Ri, CRMP5, Ma2, Yo, VGKC complex, CASPR2, LGI1, and NMDA receptor [all <5%]). CONCLUSIONS: The spectrum of PNDs is broader and the frequency is higher than previously appreciated, and selected antibody tests (SOX2, HuD, VGCC) can help determine the presence of an SCLC.
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