Evaluation of the Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes in China

Frontiers in Immunology

Fan Yang¹  Yin-Xi Zhang²  Mei-Ping Ding²  Song Qiao²  Meng-Ting Cai²  Chun-Hong Shen²  Yang Zheng³  Gao-Li Fang⁴  Qi-Lun Lai⁵ 

[1]Department of Neurology, People’s Hospital of Anyang City, Anyang, China

[2]Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China

[3]Department of Neurology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China

[4]Department of Neurology, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, China

[5]Department of Neurology, Zhejiang Hospital, Hangzhou, China

关键词: paraneoplastic neurologic syndrome;    updated diagnostic criteria;    clinical phenotype;    antibody;    cancer;   

DOI  :  10.3389/fimmu.2022.790400

来源: DOAJ

【 摘 要 】

BackgroundRecently, the paraneoplastic neurologic syndrome (PNS) diagnostic criteria have received a major update with a new score system over the past 16 years. We aimed to evaluate the diagnostic performance and clinical utility in China.MethodsAn eligible cohort of 113 Chinese patients diagnosed with PNSs from the Second Affiliated Hospital School of Medicine Zhejiang University and published data were enrolled retrospectively. Data including clinical phenotype, antibody type, the presence of cancer, and duration of follow-up were reviewed and re-evaluated to classify the diagnostic levels for the 2004 and 2021 PNS criteria. The performances of these 2 criteria were compared. The critical parameters of antibody and cancer for the updated criteria were further explored.ResultsThe cohort consisted of 69 males and 44 females with a median age of 60 years. Limbic encephalitis (23, 20.4%), anti-Hu antibody (32, 28.3%), and small-cell lung cancer (32, 28.3%) were the most common clinical phenotype, detected antibody, and concomitant cancer, respectively. A total of 97 (85.8%) patients were diagnosed with definite PNS according to the 2004 criteria: only 42.3% (41/97) fulfilled the 2021 criteria, while the remaining 40, 14, and 2 re-diagnosed with probable PNS, possible PNS, and non-PNS. The requirement of cancers consistent with antibody and phenotype increased the specificity and thus greatly enhanced the accuracy of the 2021 criteria.ConclusionThe updated criteria for PNS emphasized the consistency between cancer phenotype and antibody and showed a better diagnostic value. A better diagnostic yield could benefit disease management.

【 授权许可】

Unknown