Abstract Details

Title Evaluation of the Malignancy Risk Associated With Paraneoplastic Antibodies

Topic Autoimmune Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-024

Objective To determine the incidence of solid-organ tumor and hematologic malignancy diagnosis after being found to have a positive paraneoplastic antibody (Ab).

Background The presence of paraneoplastic Abs has been linked to most neurological conditions including central, peripheral, and autonomic disorders. This has caused an increase in the amount of tests ordered for malignancy screening, especially at tertiary centers. While the initial Abs discovered were the prototypical “paraneoplastic” entity which appear to be associated with cancer, doubt has been raised about the association between cancer risk and the more recently discovered antibodies.

Design/Methods Single center retrospective case control study of participants who had paraneoplastic Ab testing in the year 2014. We compared the incidence of malignancy over the subsequent 3 year period (2015-2017) in those with a positive Ab test with those with a negative antibody test.

Results 193 participants (median age 61 years) were identified. 49 (25%) had previously known solid-organ tumor or hematologic cancer and thus were excluded. Of the remaining 144 participants, 20 (14%) were found to have the following positive paraneoplastic Abs: 6 striational Ab, 5 N-type voltage-gated calcium channel Ab, 4 ganglionic acetylcholine-receptor Ab, 3 Voltage-gated potassium channel complex Ab, 1 acetylcholine-receptor binding Ab, and 1 P/Q-type voltage-gated calcium channel Ab. Only 1 developed cancer in the 3-year follow up period who had a positive striational Ab for an incidence of 5 per 100 participants. In the antibody negative group, 7 patients developed cancer for an incidence of 5.6 per 100 participants over the same study period. A positive paraneoplastic Ab was not correlated with the development of malignancy within a 3-year follow-up period (p=0.91).

Conclusions There was no difference in the incidence of solid tumor or hematologic malignancy between paraneoplastic antibody positive and negative participants. A larger case-control study will be conducted to further validate these results.

Authors/Disclosures
Robert J. Marquardt, DO (Cleveland Clinic) PRESENTER	Dr. Marquardt has nothing to disclose.
Moein Amin, MD (Cleveland Clinic)	Dr. Amin has nothing to disclose.
	No disclosure on file
	No disclosure on file

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