Abstract：
BACKGROUND: The link between paraneoplastic neurological syndromes (PNS) and renal cell and bladder cancer (RCC/BC) is rare and uncertain. Our aim was to clinically evaluate, in light of the updated PNS criteria, these uncommon associations.
METHODS: Retrospective nationwide cohort chart review study and systematic review of the literature.
RESULTS: After excluding 5 patients due to the diagnosis of another co-occurrent malignancy, 10/18 patients with RCC and 8/18 patients with BC were identified. A total of 31 cases were previously published, yielding an overall series of 27/49 RCC and 22/49 BC patients. There was a predominance of cerebellar syndromes in both cancers (10/27, 37% for RCC; 9/22, 41% for BC), followed by encephalitis in 9/27 (33%) patients with RCC and encephalomyelitis/sensory neuronopathy in 5/22 (23%) patients with BC. The detection of high-risk Abs was more frequent among BC patients (16/19, 84% vs. 3/13, 23% in RCC, p = 0.0009), Ri antibodies being the most frequent thereof. After applying the updated PNS criteria, patients with BC met highest degrees (possible, probable, and definite) of certainty for PNS diagnosis (20/22, 91% vs. 16/27, 59% in RCC, p = 0.021).
CONCLUSIONS: A second neoplasm should always be ruled out before establishing the diagnosis of PNS in patients with RCC or BC. However, while this association remains dubious for most patients with RCC, a casual role is more probable in patients with BC and high-risk antibodies presenting with cerebellar ataxia, brainstem encephalitis or encephalomyelitis/sensory neuronopathy.
METHODS: Retrospective nationwide cohort chart review study and systematic review of the literature.
RESULTS: After excluding 5 patients due to the diagnosis of another co-occurrent malignancy, 10/18 patients with RCC and 8/18 patients with BC were identified. A total of 31 cases were previously published, yielding an overall series of 27/49 RCC and 22/49 BC patients. There was a predominance of cerebellar syndromes in both cancers (10/27, 37% for RCC; 9/22, 41% for BC), followed by encephalitis in 9/27 (33%) patients with RCC and encephalomyelitis/sensory neuronopathy in 5/22 (23%) patients with BC. The detection of high-risk Abs was more frequent among BC patients (16/19, 84% vs. 3/13, 23% in RCC, p = 0.0009), Ri antibodies being the most frequent thereof. After applying the updated PNS criteria, patients with BC met highest degrees (possible, probable, and definite) of certainty for PNS diagnosis (20/22, 91% vs. 16/27, 59% in RCC, p = 0.021).
CONCLUSIONS: A second neoplasm should always be ruled out before establishing the diagnosis of PNS in patients with RCC or BC. However, while this association remains dubious for most patients with RCC, a casual role is more probable in patients with BC and high-risk antibodies presenting with cerebellar ataxia, brainstem encephalitis or encephalomyelitis/sensory neuronopathy.
摘要：
背景：副肿瘤神经综合征（PNS）与肾细胞和膀胱癌（RCC/BC）之间的联系很少且不确定。我们的目的是临床评估，根据更新的PNS标准，这些不寻常的协会。
方法：回顾性全国队列研究和文献系统综述。
结果：由于诊断为另一种并发恶性肿瘤而排除5例患者后，确定了10/18例RCC患者和8/18例BC患者。以前共发表了31例病例，产生27/49RCC和22/49BC患者的总体系列。两种癌症均以小脑综合征为主（10/27，RCC为37％；9/22，BC为41％），其次是9/27（33％）的RCC患者的脑炎和5/22（23％）的BC患者的脑脊髓炎/感觉神经元病变。在BC患者中，高危Abs的检测更为频繁（16/19，84%vs.3/13，碾压混凝土中23%，p=0.0009),Ri抗体是其最常见的。应用更新的PNS标准后，BC患者达到最高程度(可能，可能,并确定）PNS诊断的确定性（20/22，91%与16/27，碾压混凝土中59%，p=0.021)。
结论：在确定RCC或BC患者的PNS诊断之前，应始终排除第二肿瘤。然而,虽然这种关联对于大多数RCC患者来说仍然是可疑的，一个偶然的角色是更可能的BC和高风险的抗体表现为小脑共济失调的患者，脑干脑炎或脑脊髓炎/感觉神经病变。
方法：回顾性全国队列研究和文献系统综述。
结果：由于诊断为另一种并发恶性肿瘤而排除5例患者后，确定了10/18例RCC患者和8/18例BC患者。以前共发表了31例病例，产生27/49RCC和22/49BC患者的总体系列。两种癌症均以小脑综合征为主（10/27，RCC为37％；9/22，BC为41％），其次是9/27（33％）的RCC患者的脑炎和5/22（23％）的BC患者的脑脊髓炎/感觉神经元病变。在BC患者中，高危Abs的检测更为频繁（16/19，84%vs.3/13，碾压混凝土中23%，p=0.0009),Ri抗体是其最常见的。应用更新的PNS标准后，BC患者达到最高程度(可能，可能,并确定）PNS诊断的确定性（20/22，91%与16/27，碾压混凝土中59%，p=0.021)。
结论：在确定RCC或BC患者的PNS诊断之前，应始终排除第二肿瘤。然而,虽然这种关联对于大多数RCC患者来说仍然是可疑的，一个偶然的角色是更可能的BC和高风险的抗体表现为小脑共济失调的患者，脑干脑炎或脑脊髓炎/感觉神经病变。
