实用医学杂志 ›› 2021, Vol. 37 ›› Issue (1): 101-105.doi: 10.3969/j.issn.1006⁃5725.2021.01.021

• 调查研究 • 上一篇    下一篇

皮肌炎患者并发恶性肿瘤的影响因素

李伟念, 蔡小燕, 林小军, 袁诗雯   

  1. 广州市第一人民医院风湿免疫内科(广州 510180)
  • 出版日期:2021-01-10 发布日期:2021-01-10
  • 通讯作者: 袁诗雯 E⁃mail:13631481240@163.com
  • 基金资助:
    广 州 市 医 药 卫 生 科 技 一 般 引 导 项 目(编 号 :20171A010238)

The incidence and predictive factors of dermatomyositis complicated with malignant tumor

LI Weinian,CAI Xiaoyan,LIN Xiaojun,YUAN Shiwen
  

  1. Department of Rheumatology and Immunology,Guangzhou First People′s Hospital,School of Medicine,South China University of Technology,Guangzhou 510180,China
  • Online:2021-01-10 Published:2021-01-10
  • Contact: YUAN Shiwen E⁃mail:13631481240@163.com

摘要:

目的 探讨皮肌炎(dermatomyositis,DM)患者恶性肿瘤的发生率并评估相应的潜在危险 因素。方法 对我院 2006-2015 年的皮肌炎患者进行回顾性病例分析,内容包括一般资料、临床症状、实 验室检查结果、药物记录。研究的终点被定义为恶性肿瘤的发生或死亡。结果 皮肌炎患者发生恶性肿 59 例(24.8%),35 例(59.3%)皮肌炎诊断后 1 年内发生。仅 1 例患者肿瘤出现在 3 年后确诊。logistic 归多变量分析表明,男性性别、呼吸困难及 C 反应蛋白(C⁃reactive protein,CRP)升高为发生的危险因素, 肺间质性疾病(interstitial lung disease,ILD)是恶性肿瘤的保护性因素。结论 由于中国皮肌炎患者恶性 肿瘤的高发病率,应高度警惕这类患者合并恶性肿瘤的存在。鼻咽癌和肺癌是最常见的恶性疾病。恶性 肿瘤的风险是在皮肌炎确诊后的第 1 年发病率最高,之后降低。全身的恶性肿瘤筛查工作应在第 1 年进 行。男性性别、呼吸困难、CRP 升高是恶性肿瘤发生的危险因素。肺间质病变的存在可降低恶性肿瘤的 并存风险。

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Abstract:

Objective To investigate the incidence of malignant tumor and evaluate the potential risk factors in DM patients. Methods A retrospective case analysis was conducted on patients with dermatomyositis from 2006 to 2015 in Guangzhou First People′s Hospital,including general information,clinical symptoms,labo⁃ ratory examination results,and drug records. The end point of the study was defined as the occurrence or death of a malignant tumor. Results In this study,59 of the 238 patients with dermatomyositis had a 24.8% overall incidence of malignant tumors.Nasopharyngeal cancerand lung cancerare the most common malignant diseases. Among the 59 patients with malignant tumor,35(59.3%)developed dermatomyositis within 1 year after diagnosis. In subsequent years,and only 1 patient had tumor after the third year.multivariate Logistic regression analysis showed that the male gender,dyspneaand high level of CRP for the risk factors,Interstitial Lung Disease(ILD)was a protective factor for malignant tumor. Conclusion Due to the high incidence of Chinese patients with dermatomyositis malig⁃ nant tumor,We should be on high alert for the presence of malignant tumors in these patients. Nasopharyngeal car⁃ cinoma and lung cancer is the most common malignant disease. The risk of malignant tumor in dermatomyositis is the highest rates in the first year after diagnosis. After systemic malignant tumor screening work shall be carried out in the first year. Male gender,dyspnea,high level of CRP is risk factosr for malignant tumors occur. The presence of pulmonary interstitial disease reduces the risk of malignant tumors of coexist.

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