抗TIF1γ皮肌炎伴有和不伴有恶性肿瘤的临床和实验室特征:37个病例系列和综述

Ke‐yun Tang, Han‐lin Zhang, Xin‐yi Zhang, Hong‐zhong Jin
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摘要

我们旨在分析皮肌炎(DM)患者抗转录中间因子1抗体(抗TIF1γ-Ab)的临床概况和恶性肿瘤指标。比较了有恶性肿瘤和无恶性肿瘤的抗TIF1γ DM患者的临床信息。此外,还通过检索 PubMed 和 EMBASE 数据库,对抗 TIF1γ DM 和恶性肿瘤的相关文献进行了综述。在我们的 37 例患者中,27.0%(10/37)发生了恶性肿瘤。这10名患者罹患恶性肿瘤的时间范围从DM诊断前的21个月到DM诊断后的36个月不等。其中,一名患者在 36 岁时被诊断出患有乳腺癌。比较有恶性肿瘤和没有恶性肿瘤的组别,我们发现年龄超过 65 岁(40% vs 7.4%,P = 0.035)、从出现症状到确诊为 DM 的时间较短(2.5 vs 10 个月,P = 0.003)、红细胞沉降率(ESR)水平较高(23 vs 10 mm/h,P = 0.048)与恶性肿瘤风险增加有关。相反,出现戈特龙丘疹(63% 对 20%,P = 0.029)可能表明恶性肿瘤的可能性较低。文献综述显示,肌炎相关恶性肿瘤的发病率为 40.7%(340/836),不同系列的发病率从 19% 到 82.9% 不等。总之,年龄超过65岁、从症状出现到诊断为DM的时间较短、ESR水平升高等因素可能预示着抗TIF1γ DM患者发生恶性肿瘤的风险增加。
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Clinical and laboratory features between anti‐TIF1γ dermatomyositis with and without malignancy: 37 case series and a review
We aimed to analyze the clinical profile and malignancy indicators in dermatomyositis (DM) with anti‐transcriptional intermediary factor 1 antibody (anti‐TIF1γ‐Ab). A comparison was made between clinical information of anti‐TIF1γ DM patients with and without malignancy. Additionally, a review of the literature on anti‐TIF1γ DM and malignancy was conducted by searching PubMed and EMBASE databases. In our cohort of 37 patients, 27.0% (10/37) developed malignancy. The timeframe during which these 10 patients developed malignancy ranged from 21 months prior to the diagnosis of DM to 36 months following the diagnosis of DM. Specifically, one patient was diagnosed with breast cancer at the age of 36. Comparing the groups with and without malignancy, we found that age over 65 years (40% vs 7.4%, P = 0.035), a shorter duration from the onset of symptoms to the diagnosis of DM (2.5 vs 10 months, P = 0.003), and higher erythrocyte sedimentation rate (ESR) levels (23 vs 10 mm/h, P = 0.048) were found to be associated with an increased risk of malignancy. Conversely, the presence of Gottron's papules (63% vs 20%, P = 0.029) may suggest a lower likelihood of malignancy. The literature review revealed that the prevalence of myositis‐associated malignancy was 40.7% (340/836), with variations ranging from 19% to 82.9% across different series. In summary, factors such as age over 65 years, a shorter duration between symptom onset and diagnosis of DM, and elevated ESR levels may indicate an increased risk of malignancy in anti‐TIF1γ DM patients.
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