Department of Pulmonary Medicine, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Diagnostic Pathology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
BMC Pulm Med. 2022 May 12;22(1):191. doi: 10.1186/s12890-022-01974-4.
Inflammatory myositis, such as dermatomyositis, is sometimes complicated by cancer and is recognized as cancer-associated myositis. Although some autoimmune antibodies are considered to be involved in the development of myositis in cancer patients, the precise mechanism has not been clarified. The findings of the present case shed light on the mechanism by which anti-transcriptional intermediary factor 1 (TIF1)-γ Ab was produced and the pathogenesis of cancer-associated myositis.
We describe a case of dermatomyositis that developed in a 67-year-old man who had been diagnosed with small cell lung cancer of clinical T4N3M0 stage IIIB/limited disease during treatment. He received systemic chemotherapy and radiation therapy, and dermatomyositis developed along with a significant decrease in tumor size. TIF1-γ Ab, which is one of the myositis-specific antibodies, was found to be seroconverted. In addition, immunohistochemical analysis showed that cancer cells were positive for the TIF1-γ antigen.
The findings of the present case suggest that transcriptional intermediary factor 1-γ, which is released from tumor cells, induces the production of TIF1-γ Ab, leading to the development of dermatomyositis.
炎症性肌病,如皮肌炎,有时会并发癌症,被认为是癌相关性肌炎。虽然一些自身抗体被认为参与了癌症患者肌炎的发生,但确切的机制尚未阐明。本病例的发现阐明了抗转录中介因子 1(TIF1)-γ Ab 产生的机制以及癌相关性肌炎的发病机制。
我们描述了一例皮肌炎病例,患者为 67 岁男性,在接受治疗期间被诊断为临床 T4N3M0 期 IIIB/局限期小细胞肺癌。他接受了全身化疗和放疗,皮肌炎与肿瘤体积显著缩小同时发生。一种肌炎特异性抗体——TIF1-γ Ab 被发现转为阳性。此外,免疫组织化学分析显示癌细胞 TIF1-γ 抗原阳性。
本病例的发现提示,肿瘤细胞释放的转录中介因子 1-γ 诱导 TIF1-γ Ab 的产生,导致皮肌炎的发生。