Beijing Hospital, National Center for Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Department of Rheumatology and Immunology, The Second Xiangya Hospital, Central South University, Changsha, China.
Thorac Cancer. 2023 May;14(13):1171-1178. doi: 10.1111/1759-7714.14849. Epub 2023 Apr 12.
Although there are concerns about the association between dermatomyositis (DM) and malignancy, the clinical features in elderly DM patients with lung cancer are largely unknown. Here, we elucidated the clinical features and risk factors of lung cancer in elderly DM patients.
The data of elderly DM patients (≥65 years old) with or without lung cancer admitted to the Second Xiangya Hospital, Central South University from January 2016 to November 2022 were retrospectively analyzed.
Male patients with elderly onset DM (EODM) symptoms were found to be prone to lung cancer (p < 0.001). Elderly DM patients with lung cancer had a higher ratio of a history of smoking and were more likely to present with heliotrope rash, V sign and dysphasia and elevated monocyte-to-lymphocyte ratio (MLR) and there was a higher ratio of anti-TIF1-γ-Ab-positive patients (all p < 0.05). Occurrence of interstitial lung disease (ILD), elevated aspartate aminotransferase (AST) and anti-aminoacyl-tRNA synthetase (anti-ARS)-antibody positive rates were less common in elderly DM patients with lung cancer than those without lung cancer (all p < 0.05). Multivariate logistic regression analysis showed smoking history (p = 0.011, OR = 4.532), elevated MLR (p = 0.018, OR = 1.159) and anti-TIF1-γ-Ab-positive status (p = 0.034, OR = 8.529) were independently associated with the presence of lung cancer, while ILD might be a protective factor (p = 0.024, OR = 0.179) for lung cancer in elderly patients with DM.
Lung cancer is more common in male patients with EODM symptoms. Smoking, elevated MLR and being anti-TIF1-γ-Ab-positive were associated with higher frequencies of lung cancer in elderly DM patients. It is necessary to screen lung cancer in elderly DM patients with a history of smoking, elevated MLR or being anti-TIF1-γ-Ab-positive.
尽管人们对皮肌炎（DM）与恶性肿瘤之间的关联存在担忧，但老年 DM 合并肺癌患者的临床特征在很大程度上尚不清楚。在此，我们阐明了老年 DM 合并肺癌患者的临床特征和肺癌的危险因素。
回顾性分析了 2016 年 1 月至 2022 年 11 月期间在中南大学湘雅二医院住院的老年 DM 患者（≥65 岁）的临床资料，分为肺癌组和非肺癌组。
老年起病 DM（EODM）症状的男性患者更易发生肺癌（p<0.001）。老年 DM 合并肺癌患者有更高的吸烟史比例，更容易出现向阳疹、V 征和构音障碍，且单核细胞/淋巴细胞比值（MLR）更高，抗 TIF1-γ 抗体阳性率更高（均 p<0.05）。与非肺癌患者相比，老年 DM 合并肺癌患者的间质性肺病（ILD）、天冬氨酸转氨酶（AST）升高和抗氨酰-tRNA 合成酶（anti-ARS）抗体阳性率较低（均 p<0.05）。多因素 logistic 回归分析显示，吸烟史（p=0.011，OR=4.532）、高 MLR（p=0.018，OR=1.159）和抗 TIF1-γ 抗体阳性（p=0.034，OR=8.529）与肺癌的存在独立相关，而 ILD 可能是老年 DM 患者肺癌的保护因素（p=0.024，OR=0.179）。
EODM 症状的男性患者更易发生肺癌。吸烟、高 MLR 和抗 TIF1-γ 抗体阳性与老年 DM 患者肺癌发生率升高相关。对于有吸烟史、高 MLR 或抗 TIF1-γ 抗体阳性的老年 DM 患者，有必要进行肺癌筛查。
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