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Paraneoplastic antigens as biomarkers for early diagnosis of ovarian cancer

机译：副肿瘤抗原作为卵巢癌早期诊断的生物标志物

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Paraneoplastic syndromes are a group of rare disorders that can be triggered by an abnormal immune response to proteins from tumors of the lung, ovary, lymphatics, or breast. Paraneoplastic clinical syndromes affect 1% of patients with cancer; however, the frequency of subclinical levels of paraneoplastic autoantibodies in asymptomatic patients with cancer is unknown. Numerous studies have reported that ovarian cancer patients show signs of paraneoplastic neurological syndromes (PNSs) before or after their cancers are diagnosed. PNSs arise from a tumor-elicited immune response against onconeural antigens that are shared by tissues of nervous system, muscle, and tumor cells. Studies on the serum IgGs obtained from ovarian cancer patients have indicated the presence of onconeural antibodies in the absence of any PNS symptoms. The occurrence of PNSs is low in ovarian cancer patients and it can be accompanied by onconeural antibodies. The diagnosis of PNSs is accompanied by a suspicion of a malignant tumor such that neurologists typically refer such patients for a tumor diagnostic workup. There will be tremendous utility if subclinical levels (without paraneoplastic neurological symptoms or myositis) of these autoantibodies to paraneoplastic antigens can be exploited to screen asymptomatic high-risk patients for ovarian cancer, and used as biomarkers in immunoassays for the early detection or recurrence of ovarian cancer. Ovarian cancer overall survival is likely to be improved with early detection. Therefore, a panel of onconeural antigens that can detect paraneoplastic autoantibodies in patient sera should provide diagnostic utility for an earlier therapeutic intervention. Here we review the usefulness of PNS and other paraneoplastic syndromes and their association with paraneoplastic antigens to exploit these autoantibody biomarkers to form diagnostic multi-analyte panels for early detection of ovarian cancer. Highlights ? Paraneoplastic neurological syndromes (PNS) can occur prior to diagnosis of ovarian cancer. ? PNS can result from the occurrence of onconeural antibodies in ovarian cancer. ? Onconeural antibodies can be used as biomarkers for diagnosis of ovarian cancer.
机译：副肿瘤综合征是一类罕见的疾病，可由对肺，卵巢，淋巴管或乳腺肿瘤的蛋白质的异常免疫反应触发。副肿瘤临床综合征影响不到1％的癌症患者;然而，无症状癌症患者的亚临床副肿瘤自身抗体亚临床水平的频率尚不清楚。大量研究报告说，卵巢癌患者在诊断出癌症之前或之后显示出副肿瘤性神经综合症（PNS）的体征。 PNS源自肿瘤引起的针对神经系统，肌肉和肿瘤细胞组织共享的圆锥上抗原的免疫应答。对从卵巢癌患者获得的血清IgG的研究表明，在没有任何PNS症状的情况下，存在穿膜上抗体。卵巢癌患者中PNS的发生率很低，并且可能伴有圆锥上抗体。 PNS的诊断伴随着对恶性肿瘤的怀疑，因此神经科医生通常将此类患者转诊以进行肿瘤诊断检查。如果可以利用这些针对副肿瘤抗原的自身抗体的亚临床水平（无副肿瘤神经症状或肌炎），来筛查无症状的高危卵巢癌患者，并将其用作免疫分析中的生物标记物，以尽早发现或复发卵巢癌症。早期发现可能会改善卵巢癌的总体生存率。因此，一组可以检测患者血清中副肿瘤自身抗体的锥上抗原应为早期治疗干预提供诊断工具。在这里，我们审查了PNS和其他副肿瘤综合征的有用性，以及它们与副肿瘤抗原的关联，以利用这些自身抗体生物标记物形成诊断性多分析物组，以早期发现卵巢癌。强调 ？副肿瘤神经综合症（PNS）可以在诊断卵巢癌之前发生。 ？ PNS可能是由于卵巢癌中穿膜上抗体的出现而引起的。 ？锥上抗体可以用作诊断卵巢癌的生物标志物。

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