摘要
目的探讨神经系统副肿瘤综合征(paraneoplastic neurological syndrome,PNS)的临床表现、诊断和预后。方法回顾性分析22例PNS患者的临床特点、实验室检查结果和类型,并作文献复习。结果 22例患者中神经系统症状出现在发现肿瘤之前的14例,占63.6%;发现原发肿瘤后出现神经系统症状的8例,占36.4%。神经系统病变为周围神经病8例,周围神经病合并脊髓炎2例,周围神经病合并颅神经炎2例,周围神经病合并多发性肌炎2例,视神经炎合并癫痫2例,边缘叶脑炎2例,小脑变性2例,脑干脑炎2例。诊断原发肿瘤为4例肺癌,4例前列腺癌,4例淋巴瘤,2例白血病,2例卵巢癌,2例甲状腺癌,2例鼻咽癌,2例下咽癌。结论神经系统副肿瘤综合征临床表现复杂多样,容易误诊、漏诊,早期确诊和发现隐匿肿瘤对患者的预后起重要作用。
Objective To review the clinical features,diagnosis and prognosis of paraneoplastic neurological syndrome. Methods The clinical data,lab results and pathological types of 22 patients with paraneoplastic neurological syndrome were retrospectively reviewed. Relevant literatures were reviewed. Results Among 22 patients,14 cases had paraneoplastic neurological symptoms before the diagnosis of tumor（ 63. 6%） and 8 after tumor diagnosis（ 36. 4%）. Clinical neurological symptoms included： peripheral neuropathy in 8 cases; peripheral neuropathy with myelitis in 2 cases; peripheral neuropathy with cranial neuritis in 2 cases; peripheral neuropathy with multiple myositis in 2 cases; optic neutitis with epilepsy in 2 cases; limbic encephalitis in 2 cases; cerebellar degeneration in 2 cases; and brainstem encephalitis in 2 cases. The primary tumors included： lung cancer in 4 cases; prostatic cancer in 4 cases; lymphoma in 4 cases; leukemia in 2cases; ovarian cancer in 2 cases; thyroid cancer in 2 cases; nasopharyngeal carcinoma in 2 cases,and hypopharyngeal carcinoma in 2 case. Conclusion The clinical manifestations of paraneoplastic neurological syndrome are complicated and are likely to be misdiagnosed or missed. Early diagnosis and screening for underlying primary tumors are important for improving the prognosis.
出处
《实用肿瘤杂志》
CAS
2016年第1期59-62,共4页
Journal of Practical Oncology
关键词
副肿瘤综合征
神经系统/诊断
预后
回顾性研究
paraneoplastic syndromes
nervous system / diagnosis
prognosis
retrospective studies
