皮肌炎或多发性肌炎患者的癌症风险。一项基于人群的研究。

Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study.

作者信息

Sigurgeirsson B, Lindelöf B, Edhag O, Allander E

机构信息

Department of Dermatology, Karolinska Hospital, Stockholm, Sweden.

出版信息

N Engl J Med. 1992 Feb 6;326(6):363-7. doi: 10.1056/NEJM199202063260602.

DOI:10.1056/NEJM199202063260602

PMID:1729618

Abstract

BACKGROUND

An association between polymyositis and cancer was first proposed in 1916, but the existence of the association has been disputed. An association between dermatomyositis and cancer is better accepted, but its magnitude is not known.

METHODS

We undertook a study to provide accurate estimates of the risk of cancer in patients with dermatomyositis or polymyositis. We studied the incidence of cancer and the rate of mortality from cancer in a population-based cohort of 788 patients with dermatomyositis or polymyositis in Sweden from 1963 through 1983. The results were compared with those for the general population.

RESULTS

Among the 396 patients with polymyositis, 42 cancers were diagnosed at the same time or after polymyositis was diagnosed in 37 patients (9 percent). The relative risk of cancer was 1.8 (95 percent confidence interval, 1.1 to 2.7) in the male patients and 1.7 (95 percent confidence interval, 1.0 to 2.5) in the female patients. Eighty-four males and 85 females died, and in 24 of these cases (14 percent) cancer was the principal cause of death. The mortality ratio (the rate of mortality from cancer in these patients as compared with that in the general population) was 0.90 (95 percent confidence interval, 0.6 to 1.4). Among the 392 patients with dermatomyositis, 61 cancers were diagnosed at the same time or after dermatomyositis was diagnosed in 59 patients (15 percent). The relative risk of cancer was 2.4 (95 percent confidence interval, 1.6 to 3.6) in the male patients and 3.4 (95 percent confidence interval, 2.4 to 4.7) in the female patients. Fifty-seven males and 110 females died, and in 67 of these cases (40 percent) cancer was the principal cause of death (mortality ratio, 3.8; 95 percent confidence interval, 2.9 to 4.8).

CONCLUSIONS

The risk of cancer is increased in patients with polymyositis or dermatomyositis. In patients with dermatomyositis there is also a higher rate of mortality from cancer.

摘要

背景

1916年首次提出多发性肌炎与癌症之间存在关联，但这种关联的存在一直存在争议。皮肌炎与癌症之间的关联更被认可，但其程度尚不清楚。

方法

我们进行了一项研究，以准确估计皮肌炎或多发性肌炎患者患癌症的风险。我们研究了1963年至1983年瑞典788例皮肌炎或多发性肌炎患者的癌症发病率和癌症死亡率。将结果与普通人群的结果进行比较。

结果

在396例多发性肌炎患者中，有42例癌症在诊断多发性肌炎的同时或之后被诊断出来，其中37例患者（9%）。男性患者患癌症的相对风险为1.8（95%置信区间，1.1至2.7），女性患者为1.7（95%置信区间，1.0至2.5）。84名男性和85名女性死亡，其中24例（14%）癌症是主要死因。死亡率（这些患者的癌症死亡率与普通人群相比）为0.90（95%置信区间，0.6至1.4）。在392例皮肌炎患者中，有61例癌症在诊断皮肌炎的同时或之后被诊断出来，其中59例患者（15%）。男性患者患癌症的相对风险为2.4（95%置信区间，1.6至3.6），女性患者为3.4（95%置信区间，2.4至4.7）。57名男性和110名女性死亡，其中67例（40%）癌症是主要死因（死亡率，3.8；95%置信区间，2.9至4.8）。