Ganglionic Acetylcholine Receptor Autoantibody Oncological, Neurological, and Serological Accompaniments
Ganglionic Acetylcholine Receptor Autoantibody Oncological, Neurological, and Serological Accompaniments
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DOI：
10.1001/archneurol.2009.78
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发表时间：
2009-06-01
影响因子：
--
通讯作者：
Pittock, Sean J.
中科院分区：
文献类型：
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作者：
McKeon, Andrew;Lennon, Vanda A.;Pittock, Sean J.
目的：描述烟碱神经节乙酰胆碱受体 (α 3-AChR) 自身抗体作为神经系统自身免疫和癌症标志物的临床效用。设计：病例对照研究。地点：明尼苏达州罗切斯特市梅奥诊所。患者：梅奥诊所（2005-2007 年）共收治了 15 000 名患者，并在服务基础上进行了评估 通过病历审查以及 457 名无症状神经系统患者或对照受试者回顾性获得临床信息的副肿瘤性神经系统自身免疫病，其中 173 人为健康人，245 人患有肺癌，39 人患有系统性红斑狼疮或干燥综合征。 结果测量：α 3-AChR 的神经学、肿瘤学和血清学关联 结果：在服务测试的 15 000 名患者中，1% 为血清阳性（中位数，0.12 nmol/L；范围，0.03-18.8 nmol/L；正常，= 1.00 nmol/L），83% 患有全自主神经症。在 85 名中等抗体值 (0.10-0.99 nmol/L) 的患者中，神经系统表现更加多样化，包括周围神经病变 (36%)、自主神经功能障碍 (20%，通常有限) 和脑病 (13%)。在 58 名抗体值低（0.03-0.09 nmol/L）的患者中，54% 患有非自身免疫性神经系统疾病或无神经系统疾病。在 245 名肺癌对照患者中，7.8% 呈血清反应阳性。 212 名无癌症对照患者中只有 1 名 (0.5%) 血清反应呈阳性（P
Objective: To describe the clinical utility of the nicotinic ganglionic acetylcholine receptor (alpha 3-AChR) autoantibody as a marker of neurological autoimmunity and cancer.Design: Case-control study.Setting: Mayo Clinic, Rochester, Minnesota.Patients: A total of 15 000 patients seen at Mayo Clinic (2005-2007) and evaluated on a service basis for paraneoplastic neurological autoimmunity for whom clinical information was obtained retrospectively by medical record review as well as 457 neurologically asymptomatic patients or control subjects of whom 173 were healthy, 245 had lung cancer, and 39 had systemic lupus erythematosus or Sjogren syndrome.Outcome Measures: Neurological, oncological, and serological associations of alpha 3-AChR autoantibody seropositivity.Results: Of 15 000 patients tested on a service basis, 1% were seropositive (median, 0.12 nmol/L; range, 0.03-18.8 nmol/L; normal, = 1.00 nmol/L), 83% had pandysautonomia. Of 85 patients with medium antibody values (0.10-0.99 nmol/L), neurological presentations were more diverse and included peripheral neuropathies (36%), dysautonomia (20%, usually limited), and encephalopathy (13%). Of 58 patients with low antibody values (0.03-0.09 nmol/L), 54% had a nonautoimmune neurological disorder or no neurological disorder. Of 245 control patients with lung cancer, 7.8% were seropositive. Only 1 of 212 control patients without cancer (0.5%) was seropositive (P