The Anti-Neuronal Autoantibodies in Patients with Endometrial and Breast Cancer (P06.007)

Abstract

Objective: To evaluate the spectrum of neurological deficits and onconeural antibodies in patients with endometrial cancer and breast cancer. Background The detection of onconeural antibodies is crucial in definite diagnosis of neurological paraneoplastic syndromes (NPS). However, cancer-associated autoimmunity can be directed against other antigens expressed in nervous system. The aim of this study was to analyze the spectrum of onconeural and other neural antibodies in women with endometrial cancer (EC) and breast cancer (BC). Design/Methods: The study included 42 patients with EC hospitalized in Department of Gynecological Surgery Poznan University of Medical Sciences in Poznan and 15 patients with BC identified among 1552 subjects with suspicion of NPS and admitted to Department of Neurology at Poznan University of Medical Sciences. Indirect fluorescence was performed as a screening test and Western blotting (EUROIMMUN) as a confirmation test for the presence of onconeural antibodies in patients9 sera. Well-defined onconeural antibodies tested were : anti-Hu, anti-Yo, anti-Ri, anti-amphiphysin, anti-Ma/Ta, anti-CV2. The spectrum of evaluated anti-neural antigens included: anti-MAG (Myelin-Associated Glycoprotein), anti-GAD (Glutamic Acid Decarboxylase), anti-myelin, anti-neuroendothelium, and anti-GFAP (Glial Fibrillary Acidic Protein) antibodies. Results: EC patients frequently manifested neuropathy (21.4%), upper motor neuron syndrome (UMNS) (4.8%), bulbar palsy (2.4%), coexisting neuropathy with paraneoplastic cerebellar degeneration (PCD) (2.4%). In BC subjects PCD was the most frequent syndrome (33.3%), followed by neuropathy (13.3%), coexisting PCD with UMNS (6.7%) and plexopathy (6.6%). Anti-neural antibodies were the most frequent among EC patients (anti-myelin-9.5%, anti-MAG-7.1%) and onconeural antibodies were detected in 7.1% of patients (anti-Tr and coexisting anti-Ma/Ta with anti-CV2). In BC subjects anti-Ri were identified (26.6%), coexisting anti-Ri with anti-Yo (6.7%) as onconeural antibodies, and in 20% - anti-neural antibodies. Conclusions: Anti-neural autoimmunity is predominant in EC, while BC is associated with well defined onconeural antibodies. The dominating NPS manifestation in the course EC is neuropathy, but PCD in BC. Disclosure: Dr. Michalak has nothing to disclose. Dr. Poplawska has nothing to disclose. Dr. Szpurek has nothing to disclose. Dr. Michalak has nothing to disclose. Dr. Englert-Golon has nothing to disclose. Dr. Sajdak has nothing to disclose. Dr. Kozubski has nothing to disclose.