Kliničke i elektrofiziološke karakteristike periferne neuropatije kod starijih bolesnika sa karcinomom pluća

  • Sanja Tomanović Vujadinović Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia
  • Dragana Jovanović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Nela V. Ilić Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia
  • Emilija Dubljanin-Raspopović Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia
  • Una Nedeljković Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia
  • Branka Ilić Clinical Center of Serbia, Clinic of Physical Medicine and Rehabilitation, Belgrade, Serbia
  • Natalija Samardžić Clinical Center of Serbia, Clinic of Pulmonology, Belgrade, Serbia
  • Vesna Ćeriman Clinical Center of Serbia, Clinic of Pulmonology, Belgrade, Serbia
  • Zorica Stević University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Ljiljana Marković Denić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP180308051T
Ključne reči: pluća, neoplazme, plineuropatije, komorbiditet, stare osobe, elektrofiziologija

Sažetak


Uvod/Cilj. Zahvatanje perifernog nervnog sistema kod osoba obolelih od karcinoma pluća uobičajeno se povezuje sa paraneoplastičkim neuropatijama. Studije koje procenjuju učestalost, kliničke i elektrofiziološke karakteristike perifernih neuropatija koje nisu povezane sa onkoneuronalnim antitelima, kod ove populacije bolesnika, u proseku starije životne dobi, veoma su retke. Cilj ove studije bio je da se definišu učestalost, kao i kliničke i elektrofiziološke karakteristike idiopatskih neuropatija kod bolesnika sa karcinomom pluća u ranim stadijumima bolesti. Methods. Prikazani su klinički i elektrofiziološki podaci o 105 starijih bolesnika (63,4 ± 7,8 godina) obolelih od karcinoma pluća koji su bili podvrgnuti detaljnoj neurološkoj evaluaciji i ispitivanju provodljivosti nerava između 2013. i 2018. godine. Bolesnici sa “klasičnim” paraneoplastičnim neurološkim sindromima uz prisustvo onkoneuralnih antitela, kao i oni koji boluju od poznatih uzroka periferne neuropatije (npr. dijabetes, alkoholizam, hronična bubrežna insuficijencija, deficijencija vitamina D) isključeni su iz studije. Rezultati. U ovom istraživanju 19,1% bolesnika imalo je klinički manifestnu neuropatiju, a dodatnih 37,1% imalo je samo abnormalnosti uočene tokom ispitivanja nervne provodljivosti. Najčešći patofiziološki supstrat bila je aksonalna patologija (71,2%) sa predominantno distalnom i simetričnom distribucijom (86,4%). Zaključak. Bolesnici oboleli od karcinoma pluća u ranoj fazi bolesti pokazuju visoku učestalost klinički nemih oštećenja nerava, a prema obrascu hronične senzori-motorne distalne neuropatije lakog stepena ispoljavanja, uz predominaciju aksonalnih oštećenja. Ovi rezultati ukazuju na značaj detaljne kliničke i neurofiziološke evaluacije ove kategorije bolesnika bez tipičnih etioloških faktora za periferne neuropatije, budući da se tokom lečenja bolesnici podrgavaju nizu tretmana sa dodatnim rizikom od razvoj/pogoršanja neuropatija

Reference

Blum TG, Rich A, Baldwin D, Beckett P, De Ruysscher D, Faivre-Finn C, et al. The European initiative for quality management in lung cancer care. Eur Respir J 2014; 43(5): 1254–77.

Dubey AK, Gupta U, Jain S. Epidemiology of lung cancer and approaches for its prediction: a systematic review and analysis. Chin J Cancer 2016; 35(1): 71.

Kanaji N, Watanabe N, Kita N, Bandoh S, Tadokoro A, Ishii T, et al. Paraneoplastic syndromes associated with lung cancer. World J Clin Oncol 2014; 5(3): 197–223.

Iannuzzi MC, Scoggin CH. Small cell lung cancer. Am Rev Respir Dis 1986; 134(3): 593–608.

Elrington GM, Murray NM, Spiro SG, Newsom-Davis J. Neuro-logical paraneoplastic syndromes in patients with small cell lung cancer. A prospective survey of 150 patients. J Neurol Neurosurg Psychiatry 1991; 54(9): 764–7.

Ruelle L, Bentea G, Sideris S, El Koulali M, Holbrechts S, Lafitte JJ, et al. Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature Part 4: Neu-rological paraneoplastic syndromes, involving the peripheral nervous system and the neuromuscular junction and muscles. Lung Cancer 2017; 111: 150–63.

Croft PB, Wilkinson M. The incidence of carcinomatous neu-romyopathy in patients with various types of carcinoma. Brain 1965; 88(3): 427–34.

Graus F, Delattre JY, Antoine JC, Dalmau J, Giometto B, Grisold W, et al. Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry 2004; 75(8): 1135–40.

Key Statistics for Small Cell Lung Cancer. Atlanta, GA: American Cancer Society, Inc; 2018. Available from: https://www.cancer.org/cancer/small-cell-lung-cancer/about/key-statistics.html [accessed 2018 March 2].

Hanewinckel R, van Oijen M, Ikram MA, van Doorn PA. The epi-demiology and risk factors of chronic polyneuropathy. Eur J Epidemiol 2016; 31(1): 5–20.

Baldereschi M, Inzitari M, Di Carlo A, Farchi G, Scafato E, Inz-itari D. ILSA Working Group. Epidemiology of distal sym-metrical neuropathies in the Italian elderly. Neurology 2007; 68(18): 1460–7.

Vrancken AF, Kalmijn S, Buskens E, Franssen H, Vermeulen M, Wokke JH, et al. Feasibility and cost efficiency of a diagnostic guideline for chronic polyneuropathy: a prospective imple-mentation study. J Neurol Neurosurg Psychiatry 2006; 77(3): 397–401

Dyck PJ, Thomas PK. Polyneuropathy due to nutritional defi-ciency and alcohoism. In: Dyck PJ, Thomas PK, editors. Periph-eral Neuropathy. 3rd ed. Philadelphia, PA: W. B. Saunders; 1993. p. 1310–7.

Kimura J. Principles and variations of nerve conduction studies and assessment of individual nerves. In: Kimura J, editor. Elec-trodiagnosis in diseases of nerve and muscle, principles and practice. 3rd ed. Oxford, UK: Oxford University Press; 2001. p. 91–166.

Cornblath DR, Asbury AK, Albers JW, Feasby TE, Hahn AF, McLeod JG, et al. Research criteria for diagnosis of chronic in-flammatory demyelinating polyneuropathy (CIDP). Neurology 1991; 41(5): 617–8.

Camdessanché JP, Antoine JC, Honnorat J, Vial C, Petiot P, Con-vers P, Michel D. Paraneoplastic peripheral neuropathy associ-ated with anti-Hu antibodies. A clinical and electrophysiologi-cal study of 20 patients. Brain 2002; 125(Pt 1): 166–75.

Reck M, Popat S, Reinmuth N, De Ruysscher D, Kerr KM, Peters S. ESMO Guide-lines Working Group. Metastatic non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 25 Suppl 3: iii27–39.

Alberg AJ, Samet JM. Epidemiology of lung cancer. Chest 2003; 123(1 Suppl): 21S–49S.

Govindan R, Page N, Morgensztern D, Read W, Tierney R, Vlahio-tis A, et al. Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the sur-veillance, epidemiologic, and end results database. J Clin On-col 2006; 24(28): 4539–44.

Antoine JC, Mosnier JF, Absi L, Convers P, Honnorat J, Michel D. Carcinoma associated paraneoplastic peripheral neuropathies in patients with and without anti-onconeural antibodies. J Neurol Neurosurg Psychiatry 1999; 67(1): 7–14.

Lancaster E. Paraneoplastic Disorders. Continuum (Minneap Minn) 2017; 23(6, Neuro-oncology): 1653–79.

Chia L, Fernandez A, Lacroix C, Adams D, Planté V, Said G. Contribution of nerve biopsy findings to the diagnosis of disa-bling neuropathy in the elderly. A retrospective review of 100 consecutive patients. Brain 1996; 119( Pt 4): 1091–8.

Kararizou E, Karandreas N, Davaki P, Davou R, Vassilopoulos D. Polyneuropathies in teenagers: a clinicopathological study of 45 cases. Neuromuscul Disord 2006; 16(5): 304–7.

Burns TM, Mauermann ML. The evaluation of polyneuropa-thies. Neurology 2011; 76(7 Suppl 2): S6–13.

Notermans NC, Wokke JH, van der Graaf Y, Franssen H, van Dijk GW, Jennekens FG. Chronic idiopathic axonal polyneuropathy: a five year follow up. J Neurol Neurosurg Psychiatry 1994; 57(12): 1525–7.

Visser NA, Notermans NC, Teding van Berkhout F, van den Berg LH, Vrancken AF. Chronic obstructive pulmonary disease is not a risk factor for polyneuropathy: A prospective controlled study. Chron Respir Dis 2017; 14(4): 327–333.

Samuelsson K, Press R. Microangiopathy-A Potential Contrib-uting Factor to Idiopathic Polyneuropathy: A Mini Review. Front Neurol 2018; 9: 43.

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2021/08/19
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Vol. 77 Br. 1 (2020): Vojnosanitetski pregled
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