Shah Ami A, Rosen Antony, Hummers Laura K, May Betty J, Kaushiva Alpana, Roden Richard B S, Armstrong Deborah K, Wigley Fredrick M, Casciola-Rosen Livia, Visvanathan Kala
Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Clin Exp Rheumatol. 2017 Sep-Oct;35 Suppl 106(4):71-74. Epub 2017 Jun 19.
Systemic sclerosis (scleroderma) and dermatomyositis are two prototypic autoimmune diseases that are strongly associated with malignancy. While specific autoantibodies in these diseases are markers of an increased risk of cancer at scleroderma and dermatomyositis onset, it is not known whether these autoantibodies are biomarkers of cancer risk in patients without rheumatic disease.
In a matched case-control study of women without rheumatic disease, identified from a familial breast cancer cohort, 50 breast cancer cases and 50 controls were assayed for 3 autoantibodies that are known markers of cancer-associated scleroderma and dermatomyositis: anti-RNA polymerase III, anti-NXP2, and anti-TIF1γ.
No subject had moderate or strong autoantibody positivity. Eleven women were borderline positive for at least one autoantibody. The prevalence of borderline autoantibody positivity did not differ between cases and controls.
Our results suggest that scleroderma and dermatomyositis autoantibodies are cancer biomarkers only in patients with clinical manifestations of specific rheumatic diseases and are unlikely to improve risk stratification for cancer in the general population. However, prospective studies are needed to examine whether scleroderma and dermatomyositis autoantibodies are markers of malignancy in other cancer types.
系统性硬化症(硬皮病)和皮肌炎是两种与恶性肿瘤密切相关的典型自身免疫性疾病。虽然这些疾病中的特定自身抗体是硬皮病和皮肌炎发病时癌症风险增加的标志物,但尚不清楚这些自身抗体是否是无风湿性疾病患者癌症风险的生物标志物。
在一项从家族性乳腺癌队列中识别出的无风湿性疾病女性的匹配病例对照研究中,对50例乳腺癌病例和50例对照进行了检测,以检测3种已知的与癌症相关的硬皮病和皮肌炎标志物自身抗体:抗RNA聚合酶III、抗NXP2和抗TIF1γ。
没有受试者有中度或强自身抗体阳性。11名女性至少有一种自身抗体呈临界阳性。临界自身抗体阳性的患病率在病例组和对照组之间没有差异。
我们的结果表明,硬皮病和皮肌炎自身抗体仅在有特定风湿性疾病临床表现的患者中是癌症生物标志物,不太可能改善一般人群中癌症的风险分层。然而,需要进行前瞻性研究,以检查硬皮病和皮肌炎自身抗体是否是其他癌症类型中恶性肿瘤的标志物。