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1、ManagingParaneoplasticNeurologicalDisorders论文.freelitt【关键词】Paraneoplastic,neurological,syndromes,#8226;,Cancer,#8226;,Autoimmunity,#8226;,Autoantibodies,#8226;,Onconeural,antigensLEARNINGOBJECTIVESAfterpletingthiscourse,.freelmunepathogenesisofparaneoplas
2、ticneurologicalsyndromes.Explaintheclinicalvalueofparaneoplasticantibodydetection.Describethegeneraltreatmentapproachtoparaneoplasticneurologicalsyndromes.ABSTRACTParaneoplasticneurologicalsyndromes(PNS)areremoteeffectsofcancerthatarenotcausedbyinvasionof
3、thetumororitsmetastases.ImmunologicfactorsappearimportantinthepathogenesisofPNSbecauseantineuronalautoantibodiesandT-cellresponsesagainstnervoussystemantigenshavebeendefinedformanyofthesedisorders.Theimmunologicresponseiselicitedbytheectopicexpressionofne
4、uronalantigensbythetumor.Expressionoftheseso-called"onconeural"antigensislimitedtothetumorandthenervoussystemandsometimesalsothetestis.Atthetimeofpresentationoftheneurologicalsymptoms,mostpatientshavenotyetbeendiagnosedelyhelpfulindiagnosinganothereaspara
5、neoplastic.Inaddition,theparaneoplasticantibodiesmayalsodirectthesearchforanunderlyingneoplasm.Ontheotherhand,inpatientsknoayheraldrecurrenceofthetumororasecondtumor.Thenumberofparaneoplasticantibodiesisstillgroe,thetypeofantibody,andthepresenceorabsenceo
6、fcancer,patientsareclassifiedashavinga"definite"or"possible"PNS.DespitethepresumedautoimmuneetiologyofPNS,theresultsofvariousformsofimmunotherapyhavebeendisappointing,eexceptions.Rapiddetectionandimmediatetreatmentoftheunderlyingtumorappearstoofferthebest
7、chanceofstabilizingthepatientandpreventingfurtherneurologicaldeterioration.INTRODUCTIONParaneoplasticneurologicalsyndromes(PNS)areremoteeffectsofcancerthatare,bydefinition,causedneitherbyinvasionofthetumororitsmetastasesnorbyinfection,ischemia,metabolican
8、dnutritionaldeficits,surgery,orotherformsoftumortreatment1.ImmunologicfactorsarebelievedtobeimportantinthepathogenesisofPNSbecauseantibodiesandT-cellresponsesagainstnervoussystemantigenshavebeendefinedformanyofthese
