Axonal degeneration in the sural nerves of cancer patients.

Abstract

Peripheral nerve alteration associated with non-metastatic carcinomatous neuropathy was studied in sural nerves of 13 cancer patients and compared with 5 autopsy control nerves. Quantitative histometric analyses of the myelinated nerve fiber populations revealed a pattern of change in the sural nerves of cancer patients which was characterized by fibers undergoing acute axonal degeneration associated with either a loss of myelinated fibers or a relative increase of small myelinated fibers. This prevalence of small myelinated fibers could result from a selective destruction of large myelinated fibers and/or the presence of small regenerated myelinated fibers. The severity of sural nerve changes roughly correlated with the degree of peripheral neuropathy, but similar nerve alterations could be found in subjects with minimal or no clinical dysfunction and before the recognition of malignant disease. Thus, axonal alterations of the primary sensory neurons may appear with malignant transformation of tissues; their detection in sural nerve biopsies may be useful in facilitating the early diagnosis of cancer.