Recent Advance in Immunological Tests in Paraneoplastic Neurological Syndrome

旁腫瘤神經症候群免疫檢驗的最近進展

馮清世(Chin-Shih Fong)

《Acta Neurologica Taiwanica》 14卷1期 (2005/03) Pp. 28-35

https://doi.org/10.29819/ANT.200503.0006

摘要

旁腫瘤神經症候群雖然並不常見，但是診斷的重要性是非常大的。旁腫瘤神經症候群會以許多種不同的神經臨床症狀來表現。有許多證據顯示旁腫瘤神經症候群的致病原理來自癌症與神經系統的共同抗原的免疫反應。可藉由腦脊髓液或血清自體抗體的鑑定，來確認旁腫瘤神經症候群的臨床診斷及來早期偵測出潛在性的局部與可治療性的腫瘤。癌症的治療（手術、放射療法、化學療法）是旁腫瘤神經症候群的首要治療方法，而免疫的療法（靜脈注射免疫球蛋白、血漿置換術、免疫抑制劑）可延緩或甚至改善旁腫瘤神經症候群的病程。隨著對旁腫瘤神經症候群的自體免疫致病機轉的了解，免疫的療法將是另一種可能有效的治療選擇。

關鍵字

旁腫瘤 ； 自體抗體 ； 癌症

並列摘要

Paraneoplastic neurological syndromes are uncommon, however; their diagnosis is of major practical importance. Any portion of the nervous system may be involved in paraneoplastic syndromes. There is increasing evidence that the pathogenesis of many paraneoplastic neurological syndromes appears to be an immune reaction against antigen shared by the cancer and the nervous system. The identification of antibodies in the serum or cerebrospinal fluid in the central nervous system of paraneoplastic syndrome patient confirms the clinical diagnosis of paraneoplastic syndrome, and allows early identification of an underlying tumor at a stage when it is localized and more amenable to treatment. Cancer therapy (surgery, radiotherapy, chemotherapy) seems to be the most efficient treatment for the paraneoplastic neurological symptoms. Immunomodulatory therapy (intravenous immunoglobulin, plasmapheresis, immunosuppression) can halt or even reverse the neurological syndrome. The recent advances in understanding of the autoimmune pathology of these disorders should lead to more effective treatment options.

並列關鍵字

Paraneoplastic ； Autoantibodies ； Cancer