Clinical characteristics of paraneoplastic neurological syndrome related to different pathological lung cancers

Abstract

Background Paraneoplastic syndrome is a distant effect caused by malignant tumors, which is related to the production of cellular immune response. The nervous system is the most common involved system of paraneoplastic syndrome. It is easy to be misdiagnosed. Lung cancer is the most common cancer relating to paraneoplastic neurological syndrome (PNS). Method This study retrospectively analyzed clinical data of patients with the combination of PNS and lung cancer between January 2005 and March 2021 at Qilu Hospital of Shandong University, China. Results A total of 111 patients were diagnosed with lung cancer complicated with PNS. A total of 95 (85.6%) cases had neurological symptoms as the first symptom. Sixty‐three cases had the pathological results. A total of 43 (68.3%) of small cell lung cancer (SCLC) were diagnosed. PNS patients diagnosed with SCLC included peripheral neuropathy (15 cases, 34.9%). PNS patients diagnosed with non‐small cell lung cancer (NSCLC) included peripheral neuropathy (6 cases, 30%) and limbic encephalitis (6 cases, 30%). Anti‐Hu is popular in patients with SCLC (12 cases, 42.9%) and NSCLC (6 cases, 40%). Conclusions Most patients with PNS had neurological symptoms as the first symptom. It was more common in males. It had a higher incidence in SCLC. Peripheral neuropathy was the most common PNS associated with SCLC, followed by Lambert‐Eaton syndrome. Peripheral neuropathy and limbic encephalitis were the most common PNS associated with NSCLC. Anti‐Hu is the most common antibodies both in SCLC and NSCLC. Tumor markers do not have significant difference between different pathological types.

Initial screening for neuronal autoantibodies and their putative impact on survival in patients with small‐cell lung cancer

“…These findings indicate that screening for SOX2, Hu, and P/Q‐type VGCC autoantibodies could capture the majority of SCLCs in patients with a related PNS, but this is insufficient to be a useful tumor marker in the absence of PNS. In contrast, another study did not find SOX2 antibodies in SCLC patients with PNS 40 . We found that 20% had P/Q‐tye VGCC or Hu autoantibodies, but did not include an SOX2 autoantibody assay in our study.…”

An abundance of brain-expressed genes show ectopic activation in lung adenocarcinoma

“…Although PNS s occur in less than 0.01% of cancer patients, they are clinically important because neurological manifestations are usually diagnosed well before the underlying tumor. Lung adenocarcinoma belongs to the tumor types that were reported to give rise to PNS -inducing autoantibodies (42, 43). About 30 PNS -inducing onconeural antigens have been identified to date (44).…”

A Case of MET Exon 14 Skipping Mutation: Positive Lung Adenocarcinoma Complicated by Paraneoplastic Neurological Syndrome

“…They are reported to occur in 0.3% of all malignancies, making them relatively rare conditions [ 2 ]. The majority of malignancies associated with PNS are lung cancers, with SCLC being the most common, whereas NSCLCs such as lung adenocarcinoma are rare [ 3 , 5 ]. In this case, given the background of NSCLC, the coexistence of neuroendocrine tumors was considered and assessed; however, both morphologically and immunohistochemically, this hypothesis was dismissed.…”