腫瘍随伴症候群
WordNet
- a pattern of symptoms indicative of some disease
- a complex of concurrent things; "every word has a syndrome of meanings"
PrepTutorEJDIC
- (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2013/03/15 23:15:19」(JST)
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Paraneoplastic syndrome |
Classification and external resources |
DiseasesDB |
2064 |
eMedicine |
med/1747 |
MeSH |
D010257 |
A paraneoplastic syndrome is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells.[1] These phenomena are mediated by humoral factors (by hormones or cytokines) excreted by tumor cells or by an immune response against the tumor. Paraneoplastic syndromes are typical among middle aged to older patients, and they most commonly present with cancers of the lung, breast, ovaries or lymphatic system (a lymphoma).[2] Sometimes the symptoms of paraneoplastic syndromes show before the diagnosis of a malignancy, which has been hypothesized to relate to the disease pathogenesis. In this paradigm, tumor cells express tissue-restricted antigens (such as neuronal proteins), triggering an anti-tumor immune response which may be partially or, rarely, completely effective[3] in suppressing tumor growth and symptoms.[4][5] Patients then come to clinical attention when this tumor immune response breaks immune tolerance and begins to attack the normal tissue expressing that (e.g. neuronal) protein.
Contents
- 1 Classification
- 2 Neurological
- 3 References
- 4 External links
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Classification
Paraneoplastic syndromes can be divided into four main categories: Endocrine, neurological, mucocutaneous and hematological paraneoplastic syndromes, as well as others that may not fit into any of the above categories:
Syndrome class |
Syndrome |
Main causal cancers |
Causal mechanism |
Endocrine[6] |
Cushing syndrome |
- small-cell lung cancer[7]
- Pancreatic carcinoma[7]
- Neural tumors[7]
- Thymoma
|
Ectopic ACTH and ACTH-like substance |
SIADH |
- small-cell lung cancer[7]
- CNS malignancies[7]
|
antidiuretic hormone[7] |
Hypercalcemia |
- Lung cancer (typically squamous cell)[7]
- Breast carcinoma[7]
- Renal carcinoma[7]
- Multiple myeloma (may occur independent of osteolytic lesions)
- Adult T cell leukemia/lymphoma[7]
- Ovarian carcinoma[7]
|
PTHrP (Parathyroid hormone-related protein), TGF-α, TNF, IL-1[7] |
Hypoglycemia |
- Fibrosarcoma[7]
- Other mesenchymal sarcomas[7]
- Insulinoma
- Hepatocellular carcinoma[7]
|
Insulin or insulin-like substance[7] or "big" IGF-II |
Carcinoid syndrome |
- Bronchial adenoma (carcinoid type)[7]
- Pancreatic carcinoma[7]
- Gastric carcinoma[7]
|
Serotonin, bradykinin[7] |
Polycythemia |
|
See hematological paraneoplastic syndromes |
Hyperaldosteronism |
- Adrenal adenoma / Conn's syndrome
- Non-Hodgkin's lymphoma
- ovarian carcinoma
- pulmonary
|
Aldosterone[8] |
Neurological[9] |
Lambert-Eaton myasthenic syndrome (LEMS) |
|
Immunologic |
Paraneoplastic cerebellar degeneration |
- lung
- ovarian cancer
- breast carcinoma
|
|
Encephalomyelitis |
|
inflammation of the brain and spinal cord |
Limbic encephalitis |
- small-cell lung carcinoma
|
|
Brainstem encephalitis |
|
|
Paraneoplastic Opsoclonus (involving eye movement)-Myoclonus |
- breast carcinoma
- ovarian carcinoma
- small-cell lung carcinoma
- neuroblastoma (in children)
|
Autoimmune reaction against the RNA-binding protein Nova-1[10] |
Anti-NMDA receptor encephalitis |
|
Autoimmune reaction against NMDA-receptor subunits |
Polymyositis |
- Non-Hodgkin lymphoma
- lung cancers
- bladder cancers
|
|
Mucocutaneous[12] |
Acanthosis nigricans |
- Gastric carcinoma[7]
- Lung carcinoma[7]
- Uterine carcinoma[7]
|
- Immunologic[7]
- Secretion of EGF
|
Dermatomyositis |
- Bronchogenic carcinoma[7]
- Breast carcinoma[7]
- ovarian cancer
- pancreatic cancer
- stomach cancer
- colorectal cancer
- Non-hodgkin's lymphoma [13]
|
Immunologic[7] |
Leser-Trélat sign |
|
|
Necrolytic migratory erythema |
Glucagonoma |
|
Sweet's syndrome |
|
|
Florid cutaneous papillomatosis |
|
|
Pyoderma gangrenosum |
|
|
Acquired generalized hypertrichosis |
|
|
Hematological[14] |
Granulocytosis |
|
G-CSF |
Polycythemia |
- Renal carcinoma[7]
- Cerebellar hemangioma[7]
- Hepatocellular carcinoma[7]
|
Erythropoietin[7] |
Trousseau sign |
- Pancreatic carcinoma[7]
- Bronchogenic carcinoma[7]
|
Mucins that activate clotting,[7] others |
Nonbacterial thrombotic endocarditis |
|
Hypercoagulability[7] |
Anemia |
|
Unknown[7] |
Others |
Membranous glomerulonephritis |
|
- Tumor antigens[7]
- Immune complexes[7]
|
Tumor-induced osteomalacia |
- Hemangiopericytoma
- Phosphaturic mesenchymal tumor[15]
|
- FGF-23 (Fibroblast growth factor-23)
|
Stauffer syndrome |
|
|
Neoplastic fever [16] |
|
|
Neurological
A particularly devastating form of paraneoplastic syndromes is a group of disorders classified as paraneoplastic neurological disorders (PNDs).[17] These paraneoplastic disorders affect the central or peripheral nervous system; some are degenerative,[18] though others (such as LEMS) may improve with treatment of the condition or the tumour. Symptoms of paraneoplastic neurological disorders may include ataxia (difficulty with walking and balance), dizziness, nystagmus (rapid uncontrolled eye movements), difficulty swallowing, loss of muscle tone, loss of fine motor coordination, slurred speech, memory loss, vision problems, sleep disturbances, dementia, seizures, sensory loss in the limbs.
The most common cancers associated with paraneoplastic neurological disorders are breast, ovarian and lung cancer, but many other cancers can produce paraneoplastic symptoms as well.
Treatment options include:
- Therapies to eliminate the underlying cancer such as chemotherapy, radiation and surgery, and
- Therapies to reduce or slow neurological degeneration. Rapid diagnosis and treatment are critical for the patient to have the best chance of recovery. Since these disorders are relatively rare, few doctors have seen or treated PNDs. Therefore, it is important that PND patients consult with a specialist with experience in diagnosing and treating paraneoplastic neurological disorders.
References
- ^ Paraneoplastic Syndromes, 2011, Darnell & Posner
- ^ NINDS Paraneoplastic Syndromes Information Page National Institute of Neurological Disorders and Stroke
- ^ Darnell,R.B., DeAngelis,L.M. (1993), "Regression of small-cell lung carcinoma in patients with paraneoplastic neuronal antibodies", Lancet 341 (8836): 21-22, PMID 8093269
- ^ Roberts,W.K., Darnell,R.B. (2004), "Neuroimmunology of the paraneoplastic neurological degenerations", Current Opinions in Immunology 16 (5): 616-622, doi:10.1016/j.coi.2004.07.009, PMID 15342008
- ^ Albert,M.A., Darnell,R.B. (2004), "Paraneoplastic neurological degenerations: keys to tumour immunity", Nature Reviews Cancer 4 (1): 36-44, PMID 14708025
- ^ Paraneoplastic+endocrine+syndromes at the US National Library of Medicine Medical Subject Headings (MeSH)
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao Table 6-5 in: Mitchell, Richard Sheppard; Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson (2007). Robbins Basic Pathology. Philadelphia: Saunders. ISBN 1-4160-2973-7. 8th edition.
- ^ Mulatero P, Rabbia F, Veglio F. "Paraneoplastic hyperaldosteronism associated with non-Hodgkin's lymphoma.", New England Journal of Medicine. 2001 May 17;344(20):1558-9. Retrieved on 29 August 2012.
- ^ Nervous+system+paraneoplastic+syndromes at the US National Library of Medicine Medical Subject Headings (MeSH)
- ^ Buckanovich RJ, Posner JB, Darnell RB (1993). "Nova, the paraneoplastic Ri antigen, is homologous to an RNA-binding protein and is specifically expressed in the developing motor system". Neuron 11 (4): 657–72. doi:10.1016/0896-6273(93)90077-5. PMID 8398153.
- ^ Dalmau J, Tüzün E, Wu HY et al. (January 2007). "Paraneoplastic Anti–N-methyl-D-aspartate Receptor Encephalitis Associated with Ovarian Teratoma". Ann. Neurol. 61 (1): 25–36. doi:10.1002/ana.21050. PMC 2430743. PMID 17262855. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2430743/.
- ^ Cohen PR, Kurzrock R (1997). "Mucocutaneous paraneoplastic syndromes". Semin. Oncol. 24 (3): 334–59. PMID 9208889.
- ^ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)03540-6/abstract
- ^ Staszewski H (1997). "Hematological paraneoplastic syndromes". Semin. Oncol. 24 (3): 329–33. PMID 9208888.
- ^ Zadik Y, Nitzan DW (October 2011). "Tumor induced osteomalacia: A forgotten paraneoplastic syndrome?". Oral Oncol 48 (2): e9–10. doi:10.1016/j.oraloncology.2011.09.011. PMID 21985764.
- ^ Zell JA, Chang JC. Neoplastic fever: a neglected paraneoplastic syndrome. PMID 15864658
- ^ Rees JH (2004). "PARANEOPLASTIC SYNDROMES: WHEN TO SUSPECT, HOW TO CONFIRM, AND HOW TO MANAGE". J. Neurol. Neurosurg. Psychiatr. 75 Suppl 2 (Suppl 2): ii43–50. doi:10.1136/jnnp.2004.040378. PMC 1765657. PMID 15146039. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1765657/.
- ^ Darnell RB, Posner JB (2006). "Paraneoplastic syndromes affecting the nervous system". Semin Oncol 33 (3): 270–98. doi:10.1053/j.seminoncol.2006.03.008. PMID 16769417.
External links
- http://www.antibodypatterns.com/hu.php
Pathology: Tumor, Neoplasm, Cancer, and Oncology (C00–D48, 140–239)
|
|
Conditions |
Benign tumors |
- Hyperplasia
- Cyst
- Pseudocyst
- Hamartoma
|
|
Malignant progression |
- Dysplasia
- Carcinoma in situ
- Cancer
- Metastasis
|
|
Topography |
- Head/Neck (Oral, Nasopharyngeal)
- Digestive system
- Respiratory system
- Bone
- Skin
- Blood
- Urogenital
- Nervous system
- Endocrine system
|
|
Histology |
- Carcinoma
- Sarcoma
- Blastoma
- Papilloma
- Adenoma
|
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Other |
- Precancerous condition
- Paraneoplastic syndrome
|
|
|
Staging/grading |
- TNM
- Ann Arbor
- Prostate cancer staging
- Gleason Grading System
- Dukes classification
|
|
Carcinogenesis |
- Cancer cell
- Carcinogen
- Tumor suppressor genes/oncogenes
- Clonally transmissible cancer
- Oncovirus
- Cancer bacteria
|
|
Misc. |
- Research
- List of oncology-related terms
- History
- Cancer pain
|
|
|
|
Paraneoplastic syndromes
|
|
Endocrine |
Hypercalcaemia · SIADH · Zollinger–Ellison syndrome · Cushing's syndrome
|
|
Hematological |
Granulocytosis · Multicentric reticulohistiocytosis
|
|
Neurological |
Paraneoplastic cerebellar degeneration · Encephalomyelitis · Limbic encephalitis · Opsoclonus · Polymyositis · Transverse myelitis · Lambert–Eaton myasthenic syndrome · Anti-NMDA receptor encephalitis
|
|
Musculoskeletal |
Dermatomyositis · Hypertrophic osteoarthropathy
|
|
Mucocutaneous |
reactive erythema: Erythema gyratum repens · Necrolytic migratory erythema
papulosquamous: Acanthosis nigricans · Acquired ichthyosis · Acrokeratosis paraneoplastica of Bazex · Extramammary Paget's disease · Florid cutaneous papillomatosis · Leser-Trélat sign · Pityriasis rotunda · Tripe palms
other/ungrouped: Febrile neutrophilic dermatosis · Pyoderma gangrenosum · Paraneoplastic pemphigus
|
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UpToDate Contents
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English Journal
- A prospective open-label study of sirolimus for the treatment of anti-Hu associated paraneoplastic neurological syndromes.
- de Jongste AH, van Gelder T, Bromberg JE, de Graaf MT, Gratama JW, Schreurs MW, Hooijkaas H, Sillevis Smitt PA.
- Neuro-oncology.Neuro Oncol.2014 Jul 3. pii: nou126. [Epub ahead of print]
- BACKGROUND: Several lines of evidence suggest a T cell-mediated immune response in paraneoplastic neurological syndromes with anti-Hu antibodies (Hu-PNS). In order to investigate whether suppression of T cell-mediated immune responses in Hu-PNS patients improved their neurological outcome, we perfor
- PMID 24994790
- Paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis: have you checked the ovaries?
- Cleverly K1, Gambadauro P, Navaratnarajah R.
- Acta obstetricia et gynecologica Scandinavica.Acta Obstet Gynecol Scand.2014 Jul;93(7):712-5. doi: 10.1111/aogs.12386. Epub 2014 Apr 29.
- Anti-N-methyl-d-aspartate receptor encephalitis is an autoimmune disorder that can occur as a paraneoplastic phenomenon related to ovarian teratomas. It is a serious but reversible condition with improved outcomes following prompt tumor removal. We report two cases from our recent experience. In the
- PMID 24773063
- Paraneoplastic Hu and CRMP5 antibodies are present in smokers without cancer or neurological disease.
- Qvale TH1, Storstein A, Mazengia K, Eagan TM, Bakke PS, Vedeler CA.
- Respirology (Carlton, Vic.).Respirology.2014 Jul;19(5):730-4. doi: 10.1111/resp.12292. Epub 2014 Apr 3.
- BACKGROUND AND OBJECTIVE: We investigated if the paraneoplastic Hu and collapsin response mediator protein 5 (CRMP5) antibodies could be used as early markers for lung cancer in smokers with or without chronic obstructive pulmonary disease (COPD).METHODS: Hu and CRMP5 antibodies were measured by rad
- PMID 24697843
Japanese Journal
- Respiration & Circulation 肺癌の腫瘍随伴症候群
- Brachial Diparesis due to Motor Neuronopathy as One of the Predominant Presenting Signs of Occult Small Cell Lung Carcinoma
- 抗NMDA受容体脳炎における高次脳機能障害と回復過程の検討
- The Japanese Journal of Rehabilitation Medicine 53(4), 330-336, 2016
- NAID 130005152495
Related Links
- What are Paraneoplastic Syndromes? Paraneoplastic syndromes are a group of rare disorders that are triggered by an abnormal immune system response to a cancerous tumor known as a ...
- Paraneoplastic syndromes — Overview covers symptoms, diagnosis, treatment of rare neurological disorders associated with cancer. ... Paraneoplastic syndromes of the nervous system are a group of rare disorders that develop in ...
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