Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Neurology, Brigham Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Muscle Nerve. 2023 Aug;68(2):142-148. doi: 10.1002/mus.27801. Epub 2023 Mar 27.
INTRODUCTION/AIMS: Myotonic dystrophies (DMs) are autosomal dominant diseases in which expression of a mutant expanded repeat mRNA leads to abnormal splicing of downstream effector genes thought to be responsible for their multisystem involvement. Cancer risk and cancer-related deaths are increased in DM patients relative to the general population. We aimed at determining the frequency and type of cancers in both DM1 and DM2 vs a non-DM muscular dystrophy cohort.
A retrospective, cross-sectional study was carried out on patients with genetically confirmed DM1, DM2, facioscapulohumeral muscular dystrophy (FSHD), and oculopharyngeal muscular dystrophy (OPMD) at our institutions from 2000 to 2020.
One hundred eighty-five DM1, 67 DM2, 187 FSHD, and 109 OPMD patients were included. Relative to non-DM, DM patients had an increased cancer risk that was independent of age and sex. Specifically, an increased risk of sex-related (ovarian) and non-sex-related (non-melanoma skin, urological, and hematological) cancers was observed in DM1 and DM2, respectively. The length of CTG repeat expansion was not associated with cancer occurrence in the DM1 group.
In addition to current consensus-based care recommendations, our findings prompt consideration of screening for skin, urological, and hematological cancers in DM2 patients, and screening of ovarian malignancies in DM1 female patients.
简介/目的:强直性肌营养不良症(DMs)为常染色体显性遗传病,其突变的扩增重复 mRNA 的表达导致下游效应基因的异常剪接,这些基因被认为与多系统受累有关。与普通人群相比,DM 患者的癌症风险和癌症相关死亡率增加。我们旨在确定 1 型肌强直性营养不良(DM1)和 2 型肌强直性营养不良(DM2)与非 DM 肌营养不良症患者的癌症发生率和类型。
对 2000 年至 2020 年间在我们机构确诊的 DM1、DM2、面肩肱型肌营养不良症(FSHD)和眼咽型肌营养不良症(OPMD)患者进行回顾性、横断面研究。
纳入 185 例 DM1 患者、67 例 DM2 患者、187 例 FSHD 患者和 109 例 OPMD 患者。与非 DM 患者相比,DM 患者的癌症风险增加,且这种风险与年龄和性别无关。具体而言,在 DM1 和 DM2 中分别观察到与性相关(卵巢)和非性相关(非黑色素瘤皮肤、泌尿系统和血液系统)癌症的风险增加。在 DM1 组中,CTG 重复扩展的长度与癌症发生无关。
除了目前基于共识的护理建议外,我们的发现提示应考虑对 DM2 患者进行皮肤、泌尿系统和血液系统癌症筛查,并对 DM1 女性患者进行卵巢恶性肿瘤筛查。