Liu Ying, Xu Lulu, Wu Hongliang, Zhao Na, Tang Yanchun, Li Xiaoping, Liang Ying
Department of Rheumatology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China.
Department of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China.
Oncol Lett. 2018 Nov;16(5):5960-5968. doi: 10.3892/ol.2018.9409. Epub 2018 Sep 5.
The present study aimed to determine the characteristics of patients with dermatomyositis (DM) in order to identify predictors of cancer in these patients. Data of 239 patients with DM, treated at Yuhuangding Hospital between 1997 and 2016, was retrospectively assessed. The patients' demographic, clinical, survival and laboratory data were analyzed. Of the 239 patients, 43 developed malignancies. In 30 (69.77%) patients, the malignancy was detected within 1 year before or after DM diagnosis. There were 15 (34.88%) fatalities. Lung cancer was the most common type of malignancy identified (n=6, 13.95%), and adenocarcinoma was the most common pathological type (n=6, 13.95%). Older age, absence of interstitial lung disease, and absence of arthralgia were demonstrated to be independent risk factors for malignancy. Myositis-specific autoantibody expression, specifically anti-TIF1γ positivity and/or anti-MDA5 negativity, was associated with cancer in patients with DM. The survival rate was significantly lower in patients with malignancy than in patients without malignancy. Patients with DM had a high incidence of malignancy and a poor prognosis. Lung cancer and adenocarcinoma are common among patients with DM in northern China. Cancer screening should be conducted in all DM patients, particularly within 1 year of DM diagnosis. Older age is a risk factor for malignancy in DM patients, while interstitial lung disease and arthralgia are protective factors. Myositis-specific autoantibody detection may be useful for cancer screening in patients with DM.
本研究旨在确定皮肌炎（DM）患者的特征，以便识别这些患者发生癌症的预测因素。对1997年至2016年在烟台毓璜顶医院接受治疗的239例DM患者的数据进行了回顾性评估。分析了患者的人口统计学、临床、生存和实验室数据。在239例患者中，43例发生了恶性肿瘤。在30例（69.77%）患者中，恶性肿瘤在DM诊断前或诊断后1年内被检测到。有15例（34.88%）死亡。肺癌是最常见的恶性肿瘤类型（n = 6，13.95%），腺癌是最常见的病理类型（n = 6，13.95%）。年龄较大、无间质性肺病和无关节痛被证明是恶性肿瘤的独立危险因素。肌炎特异性自身抗体表达，特别是抗TIF1γ阳性和/或抗MDA5阴性，与DM患者的癌症有关。恶性肿瘤患者的生存率明显低于无恶性肿瘤患者。DM患者恶性肿瘤发生率高，预后差。在中国北方，肺癌和腺癌在DM患者中很常见。所有DM患者都应进行癌症筛查，尤其是在DM诊断后1年内。年龄较大是DM患者发生恶性肿瘤的危险因素，而间质性肺病和关节痛是保护因素。肌炎特异性自身抗体检测可能有助于DM患者的癌症筛查。
