Peng J C, Sheen T S, Hsu M M
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Republic of China.
Arch Otolaryngol Head Neck Surg. 1995 Nov;121(11):1298-301. doi: 10.1001/archotol.1995.01890110072013.
To evaluate the incidence rate of nasopharyngeal carcinoma with dermatomyositis, the influence of dermatomyositis on clinical course, and complications and survival of patients with nasopharyngeal carcinoma after radiotherapy.
A retrospective study of 12 patients with nasopharyngeal carcinoma associated with dermatomyositis, with a maximum follow-up of 228 months.
Academic tertiary referral center.
There were 6441 new patients with nasopharyngeal carcinoma who were seen at the National Taiwan University Hospital, Taipei, during the period from 1970 through 1993. Twelve patients were found to have dermatomyositis.
Clinical manifestations of nasopharyngeal carcinoma with dermatomyositis.
Twenty-seven (26%) of 104 patients with dermatomyositis had an associated malignancy. Twelve of these patients were diagnosed as having nasopharyngeal carcinoma. The typical skin manifestation of dermatomyositis was found in all 12 patients. Myopathy occurred in 10 patients. Three patients died of recurrence of nasopharyngeal carcinoma, one died of a second malignancy, one died of upper gastrointestinal bleeding, and one became unavailable for follow-up. The other six patients have had disease-free survival, with a mean follow-up period of 100.5 months (range, 5 to 228 months). The 1-year survival rate was 83.8%, and the 5-year survival rate was 69.4%.
In Taiwan, dermatomyositis is associated with an increased incidence rate of nasopharyngeal carcinoma. A search for nasopharyngeal carcinoma in patients with dermatomyositis should be performed in areas prevalent for nasopharyngeal carcinoma. If present, nasopharyngeal carcinoma can precede, occur concurrently with, or follow the diagnosis of dermatomyositis. Treatment of nasopharyngeal carcinoma may affect myositic or cutaneous disease. The prognosis and survival rates of nasopharyngeal carcinoma remained unaffected by dermatomyositis. No complications were noted owing to the radiotherapy used to treat dermatomyositis.
评估鼻咽癌合并皮肌炎的发病率、皮肌炎对临床病程的影响，以及鼻咽癌患者放疗后的并发症和生存率。
对12例鼻咽癌合并皮肌炎患者进行回顾性研究，最长随访228个月。
学术性三级转诊中心。
1970年至1993年期间，台北国立台湾大学医院共收治6441例新发鼻咽癌患者。其中12例被发现合并皮肌炎。
鼻咽癌合并皮肌炎的临床表现。
104例皮肌炎患者中有27例（26%）合并恶性肿瘤。其中12例被诊断为鼻咽癌。所有12例患者均出现了皮肌炎的典型皮肤表现。10例患者出现肌病。3例患者死于鼻咽癌复发，1例死于第二种恶性肿瘤，1例死于上消化道出血，1例失访。其他6例患者无病生存，平均随访期为100.5个月（范围5至228个月）。1年生存率为83.8%，5年生存率为69.4%。
在台湾，皮肌炎与鼻咽癌发病率升高有关。在鼻咽癌高发地区，应对皮肌炎患者进行鼻咽癌筛查。如果存在鼻咽癌，其可先于皮肌炎诊断出现、与皮肌炎诊断同时出现或在皮肌炎诊断之后出现。鼻咽癌的治疗可能会影响肌病或皮肤疾病。皮肌炎对鼻咽癌的预后和生存率无影响。未观察到因治疗皮肌炎所采用的放疗引起的并发症。
