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背景神经系统的伴癌综合征(PNS)几乎总是早于肿瘤的检测。鉴于肿瘤直接影响预后和治疗,故在PNS中,对肿瘤的筛查很重要,应尽早开展。目的对已有的有关经典PNS相关肿瘤的筛选予以总结,描述了小细胞肺癌、胸腺瘤、乳房癌、卵巢癌和畸胎瘤以及睾丸癌与伴癌性边缘叶脑炎、亚急性感觉性神经元神经病、亚急性自主神经神经病、伴癌性小脑变性、伴癌性斜视性眼阵挛—肌阵挛、Lambert-Eaton肌无力综合征(LEMS)、重症肌无力和伴癌性周围神经高兴奋性的关系。方法很多研究达到Ⅳ级证据,1个研究达到Ⅲ级的水平。没有合适的证据能做出A-C级的推荐,但共识性良好实践指导(GCP)可以形成。推荐抗体的性质和一定程度的临床综合征决定了潜在肿瘤的风险和类型。对胸部筛查推荐CT,如果是阴性的,接着可行氟脱氧葡萄糖-正电子发射断层显像(FDG-PET)。乳房癌筛查先行乳腺X线检查,其次是MRI。对于盆腔区域,超声是首选,其次是CT。皮肌炎患者应行胸腹部CT,女性还应检查盆腔超声及乳腺X线,50岁以下男性应检查睾丸超声,同时50岁以上患者还应行结肠镜检查。如果初查结果阴性,应3～6月内复查,于4年内每6月复查1次。LEMS患者只需复查2年。在只有某个亚组患者存在恶性肿瘤的综合征中,肿瘤标记物有预测可能的恶性肿瘤的附加价值。
Background Associated cancer syndrome (PNS) of the nervous system is almost always earlier than the detection of tumors. Since tumors directly affect prognosis and treatment, screening of tumors in PNS is important and should start as soon as possible. PURPOSE: To summarize the available screening of classical PNS-related tumors and to describe the clinical characteristics of small cell lung cancer, thymoma, breast cancer, ovarian cancer and teratoma as well as cancer of the cancerous border encephalitis and subacute sensory nerves Metamorphosis, Subacute Autonomic Neuropathies, Complicated Cerebellar Degeneration, Associated Carcinoma Strabismus-Myoclonus, Lambert-Eaton Muscular Dysfunction Syndrome (LEMS), Myasthenia Gravis and Complicated Carcinoid Peripheral Nerve Sexual relations. Methods Many studies have reached grade IV evidence and one study reached grade III. There is no suitable evidence to make A-C recommendations, but Consensus Good Practice Guidance (GCP) can be developed. The nature of the recommended antibody and some degree of clinical syndrome determine the risk and type of potential tumor. CT is recommended for chest screening and, if negative, fluorodeoxyglucose-positron emission tomography (FDG-PET). Breast cancer screening mammography first, followed by MRI. For the pelvic region, ultrasound is preferred, followed by CT. Dermatomyositis patients should be performed chest and abdomen CT, women should also check the pelvic ultrasound and mammography, men under 50 should check the testicular ultrasound, at the same time over the age of 50 patients should also be colonoscopy. If the initial test results negative, should be 3 to 6 months review, in 4 years review every 6 months. LEMS patients only need to review for 2 years. Tumor markers have the added value of predicting possible malignancies in a syndrome in which only one subgroup of patients has a malignancy.