Department of Rheumatology, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.
Rheumatol Int. 2013 Apr;33(4):965-71. doi: 10.1007/s00296-012-2489-y. Epub 2012 Jul 26.
The South Australian (SA) myositis database has registered all patients with biopsy-proven inflammatory myositis in SA from 1980 to 2009. We determined the incidence and associations of malignancy in myositis by linking this database with the SA cancer registry. Standardized incidence ratios (SIR) for malignancy were determined using the total SA population over the same time period, stratified by age and gender. The SIR for cancer in the myositis population (n = 373) was 1.39, p = 0.047. There was a trend towards an increased SIR in dermatomyositis but no increased risk of malignancy in polymyositis or inclusion body myositis. Malignancies of the lung and prostate were the commonest and 28 % of malignancies occurred within one year of IIM diagnosis. The odds of developing cancer were significantly raised in the presence of a shawl sign, male gender, and in patients with overlap syndrome or rheumatoid arthritis whilst myalgia was a significant protective factor. HLA-A28 allele was overrepresented in patients with malignancy (11 vs 2 %, p = 0.006). Patients in SA with myositis are at modestly increased risk for malignancy. We report clinical and genetic risk factors allowing the identification of patients at greatest risk for malignancy.
南澳大利亚（SA）肌炎数据库自 1980 年至 2009 年登记了所有经活检证实的炎症性肌炎患者。我们通过将该数据库与南澳大利亚癌症登记处相联系，确定了肌炎中恶性肿瘤的发病率和关联。使用同一时期的总南澳大利亚人口，按年龄和性别分层，确定恶性肿瘤的标准化发病比（SIR）。肌炎人群（n = 373）的癌症 SIR 为 1.39，p = 0.047。皮肌炎的 SIR 呈上升趋势，但多发性肌炎或包涵体肌炎无恶性肿瘤风险增加。肺癌和前列腺癌是最常见的恶性肿瘤，28%的恶性肿瘤发生在 IIM 诊断后一年内。披肩征、男性、重叠综合征或类风湿关节炎患者的癌症发病几率显著升高，而肌痛是显著的保护因素。恶性肿瘤患者 HLA-A28 等位基因过度表达（11 对 2%，p = 0.006）。南澳大利亚的肌炎患者恶性肿瘤发病风险适度增加。我们报告了临床和遗传风险因素，这些因素可以识别恶性肿瘤风险最大的患者。
