Myositis Center, Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, 3601 5th Avenue, Suite 2B, Pittsburgh, PA 15261, USA; VA Pittsburgh Healthcare System, Pittsburgh, 4100 Allequippa St, Pittsburgh, PA 15219, USA.
Myositis Center, Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, 3601 5th Avenue, Suite 2B, Pittsburgh, PA 15261, USA; UPMC Arthritis and Autoimmunity Center, Falk Medical Building, 3601 Fifth Avenue, Suite 2B, Pittsburgh, PA 15213, USA.
Rheum Dis Clin North Am. 2020 Aug;46(3):565-576. doi: 10.1016/j.rdc.2020.05.006. Epub 2020 Jun 7.
The idiopathic inflammatory myopathies, particularly dermatomyositis, are associated with an increased risk of cancer. Lung, ovarian, breast, colon, prostate, and cervical cancers, and hematologic malignancies, are among the most common associated cancers. Risk stratification for cancer in patients with myositis is based on clinical risk factors/red flags, myositis clinical subtypes, and myositis-specific autoantibodies. Clinical risk factors include older age at disease onset, male gender, dysphagia, acute onset/refractory myositis, cutaneous ulceration, necrosis/vasculitis, and elevated inflammatory markers. Appropriate screening strategies are based on the risk level. Further studies are warranted to determine the role of advanced imaging and comprehensive cancer screening.
特发性炎性肌病,尤其是皮肌炎,与癌症风险增加相关。肺癌、卵巢癌、乳腺癌、结肠癌、前列腺癌和宫颈癌以及血液系统恶性肿瘤是最常见的相关癌症。肌炎患者的癌症风险分层基于临床危险因素/警示信号、肌炎临床亚型和肌炎特异性自身抗体。临床危险因素包括发病年龄较大、男性、吞咽困难、急性发作/难治性肌炎、皮肤溃疡、坏死/血管炎和炎症标志物升高。适当的筛查策略基于风险水平。需要进一步研究来确定先进影像学和全面癌症筛查的作用。