Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study
Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study
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DOI：
10.1371/journal.pone.0143558
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发表时间：
2015-11-25
期刊：
影响因子：
3.7
通讯作者：
Maddison, Paul
中科院分区：
文献类型：
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作者：
Gozzard, Paul;Chapman, Caroline;Maddison, Paul
目的据报道，与神经元抗体 (Neur-Abs) 相关的副肿瘤性神经系统疾病 (PND) 患者的小细胞肺癌 (SCLC) 生存结果良好，但 PND 的存在可能会加快诊断速度。我们的目的是确定独立于临床神经学特征的神经元抗体是否与 SCLC 生存相关。实验设计对 262 名连续 SCLC 患者进行了检查：其中，24 名患有神经系统疾病的患者被排除在本研究之外。其余 238 人在癌症诊断时接受了广泛的神经抗体检测；生存时间根据随访临床数据确定。结果非 PND 队列 (n = 238) 的中位生存期为 9.5 个月。 103 名患者 (43%) 具有一种或多种抗原定义的神经抗体。我们发现，23 名使用 HuD/抗神经元核抗体 1 型（ANNA-1，13.0 个月，P = 0.037）的患者的中位生存期显着较长（n = 56，24%），但使用任何其他抗原定义的抗体，包括 PND 相关 SOX2（n = 56，24%）则没有。另外 28 名患者 (12%) 具有未表征的抗神经元核抗体 (ANNA-U)；与非神经元抗核抗体患者的生存时间（使用 HEp-2 细胞检测，n = 23 (10%)，9.25 个月）相比，他们的中位生存时间更长（15.0 个月，P = 0.0048）。在多变量分析中，ANNA-1 和 ANNA-U 均独立降低死亡风险，比率分别为 0.532 (P = 0.01) 和 0.430 (P
PurposeFavourable small cell lung carcinoma (SCLC) survival outcomes have been reported in patients with paraneoplastic neurological disorders (PNDs) associated with neuronal antibodies (Neur-Abs), but the presence of a PND might have expedited diagnosis. Our aim was to establish whether neuronal antibodies, independent of clinical neurological features, correlate with SCLC survival.Experimental Design262 consecutive SCLC patients were examined: of these, 24 with neurological disease were excluded from this study. The remaining 238 were tested for a broad array of Neur-Abs at the time of cancer diagnosis; survival time was established from follow-up clinical data.ResultsMedian survival of the non-PND cohort (n = 238) was 9.5 months. 103 patients (43%) had one or more antigen-defined Neur-Abs. We found significantly longer median survival in 23 patients (10%) with HuD/anti-neuronal nuclear antibody type 1 (ANNA-1, 13.0 months P = 0.037), but not with any of the other antigen-defined antibodies, including the PND-related SOX2 (n = 56, 24%). An additional 28 patients (12%) had uncharacterised anti-neuronal nuclear antibodies (ANNA-U); their median survival time was longer still (15.0 months, P = 0.0048), contrasting with the survival time in patients with non-neuronal anti-nuclear antibodies (detected using HEp-2 cells, n = 23 (10%), 9.25 months). In multivariate analyses, both ANNA-1 and ANNA-U independently reduced the mortality hazard by a ratio of 0.532 (P = 0.01) and 0.430 (P