以神经副癌综合征为首发症状的肺癌临床分析

目的 了解以神经副癌综合征为首发症状的原发性肺癌的临床特征。方法 回顾分析97例经病理和细胞学检查确诊的、以神经副癌综合征为首发症状的原发性肺癌病人的临床资料。结果 以神经副癌综合征为首发症状的原发性肺癌病人占同期肺癌住院人数的2．0％（97／4835），其中肌无力综合征35例（36．1％），多发性肌炎与皮肌炎19例（19．6％），周围神经病16例（16．5％），脑病及亚急性小脑变性各10例（10．3％），脊髓病变7例（7．2％）。首诊误诊率为88．7％（86／97）。结论 对有神经副癌综合征且年龄在45岁以上病人，应寻找有无隐匿性肺癌病灶，以减少肺癌的误（漏）诊率。

CLINICAL ANALYSIS OF LUNG CANCER WITH NEUROLOGICAL PARANEOPLASTIC SYNDROME AS INITIAL SYMPTOM

Objective To investigate the clinical characteristics of lung cancer with neurological paraneoplastic syndrome （NPS） as initial symptom. Methods Clinical data of lung cancer patients with NPS as initial symptom confirmed by pathology or cytology were analyzed retrospectively. Results Of the hospitalized patients, who with neurological paraneoplastic syndromes as initial symptom accounted for 2.0 % of lung cancer （97/4 835）, which included myasthenia syndrom （36.1%, 35/97）, polymyositis anddermatomyositis （19.6%, 19/97）, peripheral neuropathy （16.5%, 16/97）, encephalopathy （10.3%,10/97）, subacute cerebellar degeneration （10.3%, 10/97） and spinal cord lesions （7.2%,7/97）. The misdiagnosis rate at first visit was 88.7 （86/97）. Conclusion For patients over 45 years old with NPS, an investigation is required in order to find the possibility of concealed lung cancer and decrease its misdiagnosis.