Mohamed Shirine, Pruna Lelia, Kaminsky Pierre
Hôpitaux de Brabois, centre de référence des maladies neuromusculaires, centre hospitalier universitaire de Nancy, service de médecine interne orientée vers les maladies orphelines et systémiques, pôle des spécialités médicale, bâtiment Philippe-Canton, rue du Morvan, 54500 Vandoeuvre, France.
Presse Med. 2013 Sep;42(9 Pt 1):e281-4. doi: 10.1016/j.lpm.2013.01.052. Epub 2013 Mar 7.
Myotonic dystrophy type 1 (DM1) is characterized by an unstable expansion of a CTG repeat resulting in altered mRNA biogenesis. Benign or malignant tumours are increasingly reported. The aim of the study was to evaluate the risk of tumor in a cohort of patients DM1.
We retrospectively reviewed the medical records of every DM1 patient admitted in our neuromuscular center. Diagnoses of cancer and age at diagnosis were noted. The relative risk of a selected cancer was calculated using the data of the cancer registry obtained from the French "Institut de Veille Sanitaire".
A total of 109 French DM1 patients, aged 44.1±13.0 years, were studied, and 14 malignant tumours were observed, with a significant relative risk (RR) of thymoma, of gynaecologic cancers, of lung cancers.
While this cohort is small, our findings nevertheless suggest an increased risk of particular cancers in DM1. The toxic effects of mutant RNA may possibly affect oncogene expression or growth factor signalling pathways in cells. Clinical practice should include cancer screening and prevention of risk factors in DM1 patients.
1型强直性肌营养不良症(DM1)的特征是CTG重复序列不稳定扩增,导致mRNA生物合成改变。良性或恶性肿瘤的报道日益增多。本研究的目的是评估一组DM1患者的肿瘤风险。
我们回顾性分析了在我们神经肌肉中心住院的每一位DM1患者的病历。记录癌症诊断及诊断时的年龄。使用从法国“卫生监测研究所”获得的癌症登记数据计算特定癌症的相对风险。
共研究了109例法国DM1患者,年龄为44.1±13.0岁,观察到14例恶性肿瘤,胸腺瘤、妇科癌症、肺癌的相对风险显著。
虽然该队列规模较小,但我们的研究结果表明DM1患者患特定癌症的风险增加。突变RNA的毒性作用可能会影响细胞中的癌基因表达或生长因子信号通路。临床实践应包括对DM1患者进行癌症筛查和危险因素预防。