Shao Chi, Li Shan, Sun Yuxin, Zhang Ying, Xu Kai, Zhang Xin, Huang Hui
Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District.
International Medical Service Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, #1 Shuaifuyuan Street, Dongcheng District.
Medicine (Baltimore). 2020 Aug 21;99(34):e21899. doi: 10.1097/MD.0000000000021899.
Although a strong association between idiopathic inflammatory myositis (IIM) and malignancy has been widely reported, few studies have solely focused on the concurrence of dermatomyositis (DM) and malignancies (DM-malignancy).We conducted a retrospective analysis of 37 DM-malignancy cases among 363 DM patients admitted to our hospital between January 2012 and December 2017.(1) The mean age at DM diagnosis was higher for DM-malignancy patients than for DM-non-malignancy patients [(54.76 ± 9.77) years vs (48.57 ± 12.82) years, t = 2.84, P = .005]. (2) Gynecological malignancies (35.90%/14 cases) were the most common malignancies. Malignancies were diagnosed before DM for 7 DM-malignancy patients. The interval between the DM and malignancy diagnoses for the remaining 32 DM-malignancy patients was less than 6 months for 18 patients (46.15%), less than 1 years for 23 patients (58.9%), and less than 2 years for 29 patients (74.26%). (3) There was no significant difference either in antinuclear antibody or anti-Ro-52 positivity between the 2 groups (P > .05). (4) Multivariate analysis demonstrated that DM onset age ≥50 years and concurrence with ILD increased the risk of death for DM patients [hazard ratio (HR): 1.62 and 2.72; 95% confidence interval (CI): (1.08-2.43) and (1.47-5.02); P = .02 and 0.001, respectively], and male gender decreased the risk of death [HR 0.66, 95% CI (0.44-0.98), P = .04]. DM-malignancy patients were older than DM-non-malignancy patients. Gynecological malignancies were the most common malignancies among these patients. A DM onset age ≥50 years, female sex and the presence of ILD were independent risk factors for death.
尽管特发性炎性肌病（IIM）与恶性肿瘤之间的强关联已被广泛报道，但很少有研究专门关注皮肌炎（DM）与恶性肿瘤的并发情况（DM-恶性肿瘤）。我们对2012年1月至2017年12月期间我院收治的363例DM患者中的37例DM-恶性肿瘤病例进行了回顾性分析。（1）DM-恶性肿瘤患者DM诊断时的平均年龄高于DM-非恶性肿瘤患者[（54.76±9.77）岁对（48.57±12.82）岁，t=2.84，P=0.005]。（2）妇科恶性肿瘤（35.90%/14例）是最常见的恶性肿瘤。7例DM-恶性肿瘤患者的恶性肿瘤在DM之前被诊断。其余32例DM-恶性肿瘤患者中，18例（46.15%）DM与恶性肿瘤诊断之间的间隔小于6个月，23例（58.9%）小于1年，29例（74.26%）小于2年。（3）两组间抗核抗体或抗Ro-52阳性率均无显著差异（P>0.05）。（4）多因素分析表明，DM发病年龄≥50岁和并发ILD增加了DM患者的死亡风险[风险比（HR）：1.62和2.72；95%置信区间（CI）：（1.08-2.43）和（1.47-5.02）；P分别为0.02和0.001]，而男性性别降低了死亡风险[HR 0.66，95%CI（0.44-0.98），P=0.04]。DM-恶性肿瘤患者比DM-非恶性肿瘤患者年龄更大。妇科恶性肿瘤是这些患者中最常见的恶性肿瘤。DM发病年龄≥50岁、女性性别和ILD的存在是死亡的独立危险因素。
