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Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan
Our study aimed to investigate the incidence, risk factors and time to occurrence of malignancy in patients with dermatomyositis (DM) and polymyositis (PM). The electronic medical records of 1100 patients with DM and 1164 patients with PM were studied between January 2001 and May 2019. Malignancies...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907377/ https://www.ncbi.nlm.nih.gov/pubmed/33633147 http://dx.doi.org/10.1038/s41598-021-83729-5 |
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author | Hsu, Jung-Lung Liao, Ming-Feng Chu, Chun-Che Kuo, Hung-Chou Lyu, Rong-Kuo Chang, Hong-Shiu Chen, Chiung-Mei Wu, Yih-Ru Chang, Kuo-Hsuan Weng, Yi-Ching Chang, Chun-Wei Chiang, Hsing-I. Cheng, Chih-Kuang Lee, Pai-Wei Huang, Chin-Chang Ro, Long-Sun |
author_facet | Hsu, Jung-Lung Liao, Ming-Feng Chu, Chun-Che Kuo, Hung-Chou Lyu, Rong-Kuo Chang, Hong-Shiu Chen, Chiung-Mei Wu, Yih-Ru Chang, Kuo-Hsuan Weng, Yi-Ching Chang, Chun-Wei Chiang, Hsing-I. Cheng, Chih-Kuang Lee, Pai-Wei Huang, Chin-Chang Ro, Long-Sun |
author_sort | Hsu, Jung-Lung |
collection | PubMed |
description | Our study aimed to investigate the incidence, risk factors and time to occurrence of malignancy in patients with dermatomyositis (DM) and polymyositis (PM). The electronic medical records of 1100 patients with DM and 1164 patients with PM were studied between January 2001 and May 2019. Malignancies after myositis were diagnosed in 61 (5.55%) patients with DM and 38 (3.26%) patients with PM. The cumulative incidence of malignancies in patients with DM were significantly higher than patients with PM (hazard ratio = 1.78, log-rank p = 0.004). Patients with DM had a greater risk of developing malignancy than those with PM at 40–59 years old (p = 0.01). Most malignancies occurred within 1 year after the initial diagnosis of DM (n = 35; 57.38%). Nasopharyngeal cancer (NPC) was the most common type of malignancy in patients with DM (22.95%), followed by lung, and breast cancers. In patients with PM, colorectal, lung and hepatic malignancies were the top three types of malignancy. The risk factors for malignancy included old age (≥ 45 years old) and low serum levels of creatine phosphokinase (CPK) for patients with DM and male sex and low serum levels of CPK for patients with PM. Low serum levels of CPK in patients with myositis with malignancy represented a low degree of muscle destruction/inflammation, which might be attributed to activation of the PD-L1 pathway by tumor cells, thus inducing T-cell dysfunction mediating immune responses in myofibers. A treatment and follow-up algorithm should explore the occurrence of malignancy in different tissues and organs and suggested annual follow-ups for at least 5.5 years to cover the 80% cumulative incidence of malignancy in patients with DM and PM. |
format | Online Article Text |
id | pubmed-7907377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-79073772021-03-02 Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan Hsu, Jung-Lung Liao, Ming-Feng Chu, Chun-Che Kuo, Hung-Chou Lyu, Rong-Kuo Chang, Hong-Shiu Chen, Chiung-Mei Wu, Yih-Ru Chang, Kuo-Hsuan Weng, Yi-Ching Chang, Chun-Wei Chiang, Hsing-I. Cheng, Chih-Kuang Lee, Pai-Wei Huang, Chin-Chang Ro, Long-Sun Sci Rep Article Our study aimed to investigate the incidence, risk factors and time to occurrence of malignancy in patients with dermatomyositis (DM) and polymyositis (PM). The electronic medical records of 1100 patients with DM and 1164 patients with PM were studied between January 2001 and May 2019. Malignancies after myositis were diagnosed in 61 (5.55%) patients with DM and 38 (3.26%) patients with PM. The cumulative incidence of malignancies in patients with DM were significantly higher than patients with PM (hazard ratio = 1.78, log-rank p = 0.004). Patients with DM had a greater risk of developing malignancy than those with PM at 40–59 years old (p = 0.01). Most malignancies occurred within 1 year after the initial diagnosis of DM (n = 35; 57.38%). Nasopharyngeal cancer (NPC) was the most common type of malignancy in patients with DM (22.95%), followed by lung, and breast cancers. In patients with PM, colorectal, lung and hepatic malignancies were the top three types of malignancy. The risk factors for malignancy included old age (≥ 45 years old) and low serum levels of creatine phosphokinase (CPK) for patients with DM and male sex and low serum levels of CPK for patients with PM. Low serum levels of CPK in patients with myositis with malignancy represented a low degree of muscle destruction/inflammation, which might be attributed to activation of the PD-L1 pathway by tumor cells, thus inducing T-cell dysfunction mediating immune responses in myofibers. A treatment and follow-up algorithm should explore the occurrence of malignancy in different tissues and organs and suggested annual follow-ups for at least 5.5 years to cover the 80% cumulative incidence of malignancy in patients with DM and PM. Nature Publishing Group UK 2021-02-25 /pmc/articles/PMC7907377/ /pubmed/33633147 http://dx.doi.org/10.1038/s41598-021-83729-5 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Hsu, Jung-Lung Liao, Ming-Feng Chu, Chun-Che Kuo, Hung-Chou Lyu, Rong-Kuo Chang, Hong-Shiu Chen, Chiung-Mei Wu, Yih-Ru Chang, Kuo-Hsuan Weng, Yi-Ching Chang, Chun-Wei Chiang, Hsing-I. Cheng, Chih-Kuang Lee, Pai-Wei Huang, Chin-Chang Ro, Long-Sun Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan |
title | Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan |
title_full | Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan |
title_fullStr | Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan |
title_full_unstemmed | Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan |
title_short | Reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in Taiwan |
title_sort | reappraisal of the incidence, various types and risk factors of malignancies in patients with dermatomyositis and polymyositis in taiwan |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907377/ https://www.ncbi.nlm.nih.gov/pubmed/33633147 http://dx.doi.org/10.1038/s41598-021-83729-5 |
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