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特发性炎性肌病与恶性肿瘤:全面综述。

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review.

机构信息

Division of Rheumatology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Expression, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 50 South Drive, Room 1146, Building 50, MSC 8024, Bethesda, MD, 20892, USA.

出版信息

Clin Rev Allergy Immunol. 2017 Feb;52(1):20-33. doi: 10.1007/s12016-015-8511-x.

Abstract

The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of autoimmune diseases (collectively known as myositis) affecting the skeletal muscles as well as other organ systems such as skin, lungs, and joints. The primary forms of myositis include polymyositis (PM), dermatomyositis (PM), and immune-mediated necrotizing myopathy (IMNM). Patients with these diseases experience progressive proximal muscle weakness, have characteristic muscle biopsy findings, and produce autoantibodies that are associated with unique clinical features. One distinguishing feature of these patients is that they are also known to have an increased risk of cancer. Since the first description of the association in 1916, it has been extensively reported in the medical literature. However, there have been significant variations between the different studies with regard to the degree of cancer risk in patients with IIM. These discrepancies can, in part, be attributed to differences in the definition of malignancy-associated myositis used in different studies. In recent years, significant advances have been made in defining specific features of IIM that are associated with the development of malignancy. One of these has been myositis-specific antibodies (MSAs), which are linked to distinct clinical phenotypes and categorize patients into groups with more homogeneous features. Indeed, patients with certain MSAs seem to be at particularly increased risk of malignancy. This review attempts a systematic evaluation of research regarding the association between malignancy and myositis.

摘要

特发性炎性肌病(IIM)是一组异质性自身免疫性疾病(统称为肌炎),影响骨骼肌以及皮肤、肺和关节等其他器官系统。主要的肌炎形式包括多发性肌炎(PM)、皮肌炎(PM)和免疫介导的坏死性肌病(IMNM)。这些疾病的患者会出现进行性近端肌肉无力,具有特征性的肌肉活检结果,并产生与独特临床特征相关的自身抗体。这些患者的一个显著特征是他们也有更高的患癌风险。自 1916 年首次描述这种关联以来,它在医学文献中得到了广泛报道。然而,不同研究中患者的癌症风险程度存在显著差异。这些差异部分归因于不同研究中使用的与恶性肿瘤相关的肌炎的定义不同。近年来,在定义与恶性肿瘤发生相关的特定 IIM 特征方面取得了重大进展。其中之一是肌炎特异性抗体(MSAs),它与独特的临床表型相关,并将患者分为具有更同质特征的组。事实上,某些 MSAs 的患者似乎有特别高的患癌风险。这篇综述试图对恶性肿瘤与肌炎之间的关联进行系统评估。

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