CANCER RISK FOLLOWING POLYMYOSITIS AND DERMATOMYOSITIS - A NATIONWIDE COHORT STUDY IN DENMARK
CANCER RISK FOLLOWING POLYMYOSITIS AND DERMATOMYOSITIS - A NATIONWIDE COHORT STUDY IN DENMARK
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DOI：
10.1007/bf00051675
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发表时间：
1995-01-01
影响因子：
2.3
通讯作者：
FRAUMENI, JF
中科院分区：
文献类型：
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作者：
CHOW, WH;GRIDLEY, G;FRAUMENI, JF
多发性肌炎和皮肌炎(PM/DM)与癌症有关，尽管人们对其长期风险知之甚少。为了根据PM/DM诊断后的时间段评估癌症风险，从丹麦中央医院出院登记处确定了1977至1989年间在丹麦住院的539名PM/DM患者的队列。队列成员中的癌症发病率是通过使用唯一的个人识别码与丹麦癌症登记处建立联系来确定的。在糖尿病(标准化发病率[SIR]=3.8，95%可信区间[CI]=2.6-5.4)和轻度PM患者(SIR=1.7，CI=1.1-2.4)中，总体癌症风险显著增加。在肺癌、卵巢癌、淋巴和造血系统癌中观察到明显的过度。然而，自PM/DM首次诊断以来，超额癌症发病率随着年龄的增加而稳步下降。癌症风险在第一年增加了约6倍(SIR=5.9，CI=3.8-8.7)，但在第二年降低(SIR=2.5，CI=1.1-4.8)，在随后的几年中没有明显的过度。这些发现证实了PM/DM可能是一种副肿瘤综合征，需要采取措施早期发现和治疗癌症。然而，在PM/DM的长期幸存者中，除了为普通人群推荐的措施之外，几乎没有证据表明有必要采取广泛的预防和筛查措施。
Polymyositis and dermatomyositis (PM/DM) have been associated with cancer, although the long-term risks are poorly understood. To evaluate the risk of cancer by time periods subsequent to PM/DM diagnosis, a cohort of 539 patients hospitalized with PM/DM in Denmark between 1977 and 1989 was identified from the Danish Central Hospital Discharge Register. Cancer incidence among cohort members was ascertained by linkage to the Danish Cancer Registry using a unique personal-identification number. The overall cancer risk was elevated significantly among patients with DM (standardized incidence ratio [SIR] = 3.8, 95 percent confidence interval [CI] = 2.6-5.4) and to a lesser extent PM (SIR = 1.7, CI = 1.1-2.4). Significant excesses were observed for cancers of lung, ovary, and lymphatic and hematopoietic system. However, the excess cancer incidence declined steadily with increasing years since initial diagnosis of PM/DM. The cancer risk was increased about sixfold (SIR = 5.9, CI = 3.8-8.7) during the first year, but was lower during the second year (SIR = 2.5, CI = 1.1-4.8), with no significant excesses in subsequent years of follow-up. These findings confirm that PM/DM may occur as a paraneoplastic syndrome that calls for steps aimed at early cancer detection and treatment. Among long-term survivors of PM/DM, however, there is little evidence to warrant extensive preventive and screening measures beyond those recommended for the general population.