RISK OF CANCER IN PATIENTS WITH DERMATOMYOSITIS OR POLYMYOSITIS - A POPULATION-BASED STUDY
RISK OF CANCER IN PATIENTS WITH DERMATOMYOSITIS OR POLYMYOSITIS - A POPULATION-BASED STUDY
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DOI：
10.1056/nejm199202063260602
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发表时间：
1992-02-06
影响因子：
158.5
通讯作者：
ALLANDER, E
中科院分区：
文献类型：
--
作者：
SIGURGEIRSSON, B;LINDELOF, B;ALLANDER, E
背景多发性肌炎和癌症之间的关联最早于1916年提出，但这种关联的存在一直存在争议。皮肌炎和癌症之间的联系被更好地接受，但其程度尚不清楚。我们进行了一项研究，以提供皮肌炎或多发性肌炎患者癌症风险的准确估计。我们研究了1963年至1983年瑞典788例皮肌炎或多发性肌炎患者的癌症发病率和癌症死亡率。并与一般人群的结果进行比较。在396名多发性肌炎患者中，42名癌症患者在37名患者（9%）被诊断为多发性肌炎的同时或之后被诊断为癌症。男性患者患癌症的相对风险为1.8（95%置信区间，1.1至2.7），女性患者为1.7（95%置信区间，1.0至2.5）。84名男性和85名女性死亡，其中24例（14%）癌症是主要死因。死亡率比（这些患者与普通人群的癌症死亡率相比）为0.90（95%置信区间为0.6 ~ 1.4）。在392例皮肌炎患者中，61例癌症在59例皮肌炎患者（15%）诊断的同时或之后被诊断。男性患者患癌症的相对风险为2.4（95%置信区间，1.6至3.6），女性患者为3.4（95%置信区间，2.4至4.7）。57名男性和110名女性死亡，其中67例（40%）癌症是主要死亡原因（死亡率为3.8; 95%置信区间为2.9至4.8）。多发性肌炎或皮肌炎患者患癌症的风险增加。皮肌炎患者的癌症死亡率也较高。
Background. An association between polymyositis and cancer was first proposed in 1916, but the existence of the association has been disputed. An association between dermatomyositis and cancer is better accepted, but its magnitude is not known.Methods. We undertook a study to provide accurate estimates of the risk of cancer in patients with dermatomyositis or polymyositis. We studied the incidence of cancer and the rate of mortality from cancer in a population-based cohort of 788 patients with dermatomyositis or polymyositis in Sweden from 1963 through 1983. The results were compared with those for the general population.Results. Among the 396 patients with polymyositis, 42 cancers were diagnosed at the same time or after polymyositis was diagnosed in 37 patients (9 percent). The relative risk of cancer was 1.8 (95 percent confidence interval, 1.1 to 2.7) in the male patients and 1.7 (95 percent confidence interval, 1.0 to 2.5) in the female patients. Eighty-four males and 85 females died, and in 24 of these cases (14 percent) cancer was the principal cause of death. The mortality ratio (the rate of mortality from cancer in these patients as compared with that in the general population) was 0.90 (95 percent confidence interval, 0.6 to 1.4).Among the 392 patients with dermatomyositis, 61 cancers were diagnosed at the same time or after dermatomyositis was diagnosed in 59 patients (15 percent). The relative risk of cancer was 2.4 (95 percent confidence interval, 1.6 to 3.6) in the male patients and 3.4 (95 percent confidence interval, 2.4 to 4.7) in the female patients. Fifty-seven males and 110 females died, and in 67 of these cases (40 percent) cancer was the principal cause of death (mortality ratio, 3.8; 95 percent confidence interval, 2.9 to 4.8).Conclusions. The risk of cancer is increased in patients with polymyositis or dermatomyositis. In patients with dermatomyositis there is also a higher rate of mortality from cancer.