Incidence of malignant disease in biopsy-proven inflammatory myopathy - A population-based cohort study
Incidence of malignant disease in biopsy-proven inflammatory myopathy - A population-based cohort study
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DOI：
10.7326/0003-4819-134-12-200106190-00008
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发表时间：
2001-06-19
影响因子：
39.2
通讯作者：
Giles, G
中科院分区：
文献类型：
--
作者：
Buchbinder, R;Forbes, A;Giles, G
背景：肌炎和恶性疾病之间关联的有效性和程度仍在争论。目的：确定活检证实的炎性肌病患者恶性疾病的风险。设计：基于人群的回顾性队列研究。地点：澳大利亚维多利亚。患者：从1981年到1995年首次诊断为活检阳性的特发性炎性肌病的537例患者。计算标准化发病率，比较炎性肌病患者和普通人群恶性疾病的发病率。在104例患者中，共发现116例恶性疾病。74例确诊为肌炎的同时（7天内）或确诊后。恶性疾病的最高风险与皮肌炎相关（标准化发病率比，6.2 [95%CI，3.9 - 10.0]）。多发性肌炎的风险也增加（标准化发病率比，2.0 [CI，1.4 - 2.7]），尽管皮肌炎与多发性肌炎相比恶性疾病的相对风险为2.4（CI，1.3 - 4.2）。在包涵体肌炎中也发现恶性疾病的风险增加（标准化发病率比，2.4 [CI，1.2至4.9]）。恶性疾病的额外风险随着时间的推移而减少（标准化发病比，第1年4.4 [CI，2.7 ~ 7.1]，1 ~ 3年3.4 [CI，2.3 ~ 5.1]，3 ~ 5年2.2 [CI，1.3 ~ 3.9];结论：皮肌炎和多发性肌炎患者恶性病变的危险性增加，包涵体肌炎患者恶性病变的危险性也增加。
Background: The validity and magnitude of an association between myositis and malignant disease continue to be debated. Such issues as the legitimacy of a myositis diagnosis and distinction among myositis subgroups in previous population-based studies remain unresolved.Objective: To determine the risk for malignant disease in patients with biopsy-proven inflammatory myopathies.Design: Population-based, retrospective cohort study.Setting: Victoria, Australia.Patients: 537 patients in whom a biopsy-positive idiopathic inflammatory myopathy was first diagnosed from 1981 through 1995.Measurements: standardized incidence ratios were calculated to compare the incidence of malignant disease in patients with inflammatory myopathy and the general population.Results: A total of 116 cases of malignant disease were found in 104 patients. Seventy-four cases were identified concurrently with (within 7 days) or after diagnosis of myositis. The highest risk for malignant disease was associated with dermatomyositis (standardized incidence ratio, 6.2 [95% CI, 3.9 to 10.0]). The risk was also increased in polymyositis (standardized incidence ratio, 2.0 [CI, 1.4 to 2.7]), although the relative risk for malignant disease in dermatomyositis compared with polymyositis was 2.4 (CI, 1.3 to 4.2). An increased risk for malignant disease was also found in inclusion-body myositis (standardized incidence ratio, 2.4 [CI, 1.2 to 4.9]). The excess risk for malignant disease diminished with time (standardized incidence ratio, 4.4 [CI, 2.7 to 7.1] in the first year; 3.4 [Cl, 2.3 to 5.1] between 1 and 3 years; 2.2 [Cl, 1.3 to 3.9] between 3 and 5 years; and 1.6 [Cl, 1.0 to 2.6] beyond 5 years [P for trend, 0.002]).Conclusion: The risk for malignant disease is increased in biopsy-proven dermatomyositis and polymyositis and also appears to be increased in inclusion-body myositis.