ABSTRACT
Objective. There is still no consensus about whether to perform PET/CT to detect carcinoma in paraneoplastic neurological syndromes (PNS) in patients with or without antibodies. The aim of this study is to determine the diagnostic accuracy of PET/CT and antibodies in patients with PNS. Material and Methods. A retrospective study was conducted on patients with clinically suspected PNS between 2008 and 2013. The association between histopathological findings, paraneoplastic antibodies, and PET/CT findings were evaluated. Sensitivity and specificity for the detection of underlying malignancy were calculated for PET/CT and paraneoplastic antibodies. Results. A total of 42 patients were analyzed. Of these 42 patients, 32 (75%) had a classical PNS, 6 (14%) had positive PET/CT findings, and 34 were tested for the presence of antibodies (anti-Hu Ab, anti-Yo Ab, and anti-Ri Ab). Twenty one of 34 patients had positive antibodies. Of the 6 patients with positive PET/CT findings, 6 had positive histopathological results. Among 21 patients with positive biomarkers, carcinoma was confirmed only in 5 patients. One patient with negative antibodies, but positive PET/CT findings, was diagnosed with a tumor. Gastric carcinoma was detected in 1 patient with negative PET/CT findings and antibodies during follow-up. Based on the results, PET/CT was found to have 85.71% sensitivity, 100% specificity, 100% positive and 97.22% negative predictive values in the detection of tumors. Conclusion. PET/CT has a certain diagnostic accuracy for detecting underlying malignancy in patients with PNS, regardless of the presence of paraneoplastic antibodies (AU)
Objetivo. No hay un criterio unánime para realizar PET/TC en la detección de carcinoma en pacientes de síndrome neurológico paraneoplásico (PNS), con o sin anticuerpos. Nuestro objetivo es buscar la utilidad diagnóstica de la PET/TC y los anticuerpos en pacientes con PNS. Material y métodos. Se examinaron retrospectivamente los pacientes con sospecha clínica de PNS estudiados entre 2008 y 2013. Se evaluó la asociación entre los resultados histopatológicos, los anticuerpos y los resultados de la PET/TC. Se calcularon la sensibilidad y la especificidad de la PET/TC y de los anticuerpos paraneoplásicos para la detección de malignidad. Resultados. Se analizaron un total de 42 pacientes. De ellos 32 pacientes (el 75%) tenían un PNS clásico. A todos se les había realizado PET/TC y 6 (el 14%) tuvieron resultados positivos. Se determinó la presencia de anticuerpos en 34 pacientes (anticuerpos anti-Hu, anticuerpos anti-Yo y anticuerpos anti-Ri). Veintiuno de los cuales dieron positivo. Los 6 pacientes con resultados PET/TC positivos tuvieron resultados histopatológicos positivos. Entre los 21 pacientes con biomarcadores positivos, el carcinoma se confirmó solo en 5 pacientes. A un paciente con resultado negativo para anticuerpos, pero positivo en la PET/TC, se le diagnosticó un tumor. Se detectó carcinoma gástrico en un paciente con resultados negativos en la PET/TC y anticuerpos en el periodo de seguimiento. Según los resultados, se comprobó que la PET/TC tiene un 85,71% de sensibilidad, un 100% de especificidad, con valor predictivo positivo de 100% y valor predictivo negativo de 97,22% en la detección de tumores. Conclusión. La PET/TC tiene un cierto grado de exactitud diagnóstica para detectar malignidad subyacente en pacientes con PNS, sin importar la presencia de anticuerpos paraneoplásicos (AU)
Subject(s)
Humans , Male , Female , Paraneoplastic Syndromes , Paraneoplastic Syndromes, Nervous System , Positron-Emission Tomography , Adenocarcinoma , Immunohistochemistry/methods , Immunohistochemistry , Retrospective Studies , Sensitivity and Specificity , Carcinoma , Nuclear Medicine/methodsABSTRACT
OBJECTIVE: There is still no consensus about whether to perform PET/CT to detect carcinoma in paraneoplastic neurological syndromes (PNS) in patients with or without antibodies. The aim of this study is to determine the diagnostic accuracy of PET/CT and antibodies in patients with PNS. MATERIAL AND METHODS: A retrospective study was conducted on patients with clinically suspected PNS between 2008 and 2013. The association between histopathological findings, paraneoplastic antibodies, and PET/CT findings were evaluated. Sensitivity and specificity for the detection of underlying malignancy were calculated for PET/CT and paraneoplastic antibodies. RESULTS: A total of 42 patients were analyzed. Of these 42 patients, 32 (75%) had a classical PNS, 6 (14%) had positive PET/CT findings, and 34 were tested for the presence of antibodies (anti-Hu Ab, anti-Yo Ab, and anti-Ri Ab). Twenty one of 34 patients had positive antibodies. Of the 6 patients with positive PET/CT findings, 6 had positive histopathological results. Among 21 patients with positive biomarkers, carcinoma was confirmed only in 5 patients. One patient with negative antibodies, but positive PET/CT findings, was diagnosed with a tumor. Gastric carcinoma was detected in 1 patient with negative PET/CT findings and antibodies during follow-up. Based on the results, PET/CT was found to have 85.71% sensitivity, 100% specificity, 100% positive and 97.22% negative predictive values in the detection of tumors. CONCLUSION: PET/CT has a certain diagnostic accuracy for detecting underlying malignancy in patients with PNS, regardless of the presence of paraneoplastic antibodies.
Subject(s)
Antibodies, Neoplasm/blood , Autoantibodies/blood , Carcinoma/diagnostic imaging , Paraneoplastic Syndromes, Nervous System/diagnostic imaging , Positron Emission Tomography Computed Tomography , Adolescent , Adult , Aged , Aged, 80 and over , Carcinoma/blood , Carcinoma/diagnosis , ELAV Proteins/immunology , Female , Fluorine Radioisotopes/analysis , Fluorodeoxyglucose F18/analysis , Humans , Lymphoma, Non-Hodgkin/blood , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/diagnostic imaging , Male , Middle Aged , Nerve Tissue Proteins/immunology , Neuro-Oncological Ventral Antigen , Paraneoplastic Syndromes, Nervous System/blood , Predictive Value of Tests , RNA-Binding Proteins/immunology , Radiopharmaceuticals/analysis , Retrospective Studies , Sensitivity and Specificity , Young AdultABSTRACT
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Subject(s)
Humans , Male , Child, Preschool , Neoplasms, Neuroepithelial , Positron-Emission Tomography/methods , Tuberculosis, Meningeal , Diagnosis, DifferentialABSTRACT
No disponible