A new diagnostic criterion for myositis based on clinical and pathological findings

基于临床和病理结果的肌炎新诊断标准

基本信息

批准号：
17590863
负责人：
SHIMIZU Jun
金额：
$ 2.18万
依托单位：
The University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-17590863/
关键词：
myositis classification clinical pathology 皮膚筋炎多発筋炎破壊血管 tubuloreticular profile

项目摘要

This project aimed to propose new diagnostic criteria for myositis based on clinical and pathological findings. Firstly we analyzed the frequency of diagnostic clinical and pathological findings for myositis in biopsied muscles from 126 consecutive cases with PM/DM. We found that the immunohistochemical findings of aberrant expression of MHC-I antigen on non-necrotic fibers are frequent and are good marker for detecting inflammatory changes even with sparse inflammatory cells. We also found that the findings of the invasion of CD8 positive lymphocytes into non-necrotic fibers, which findings are specific for polymyositis are about 5%, and the frequency of the findings of perifascicular atrophy and the deposition of complement complexes on endomysial capillaries are 13% and 23% respectively. Ultrastrucural observation showed that the findings of tuburoreticular profiles in endothelial cells and destruction of endomysial capillaries are other good markers for diagnosis of dermatomyositis. The multifactor analysis between clinical and pathological factors did not show correlation between clinical and pathological findings. Following above results, we proposed a new diagnostic criterion based on skin changes and immunohistochemical and ultrastructural pathological findings in biopsied muscle. The validity of the new criteria was assessed through analyzing clinical pictures of consecutive 187 cases with PM/DM. The 187 cases were classified into 10 PM cases (6%), 94DM cases (50%), 62 unclassified myositis cases (33%) and 21 probable myositis cases. It was revealed that the clinical pictures between PM and DM are quite different and the cases with malignancy, collagen disease or pulmonary fibrosis were found only in DM group. The serum cytokine profiles (GM-CSF、 IFN-γ、IL-1b,2,4,5,6,8,10,TNF-a) assessed in 69 PM/DM cases also showed the difference between PM and DM groups. The results supported the validity of the proposed new criteria.

该项目旨在根据临床和病理发现提出肌炎的新诊断标准。首先，我们分析了来自PM/DM的126例活检肌肉中肌炎的诊断临床和病理发现的频率。我们发现，MHC-1抗原在非胞质纤维上的异常表达的免疫组织化学发现频繁，即使在稀疏的炎性细胞中，也是检测炎症变化的好标记。我们还发现，CD8阳性淋巴细胞侵袭非全质纤维的发现，这些发现是针对多聚肌炎的特异性的，大约为5％，并且围膜萎缩发现的频率和互补复合物在内膜毛细血管对互补的结构的沉积分别为13％和13％和23％。超微结构观察表明，内皮细胞中的结核病特征的发现和室内物理毛细血管的破坏是诊断性皮肌炎的其他好标记。临床和病理因素之间的多因素分析没有显示临床和病理发现之间的相关性。遵循上述结果，我们提出了一个新的诊断标准，基于生存肌肉中的皮肤变化以及免疫组织化学和超微结构病理发现。通过分析的连续187例PM/DM病例的临床图片评估了新标准的有效性。将187例归类为10个下午病例（6％），94DM病例（50％），62例未分类的肌炎病例（33％）和21例有问题的肌炎病例。据透露，PM和DM之间的临床图片截然不同，并且仅在DM组中发现了恶性，胶原蛋白疾病或肺纤维化的病例。在69 pm/dm病例中评估的血清细胞因子谱（GM-CSF，IFN-γ，IL-1B，2,4,5,6,8,10，TNF-A）也显示了PM和DM组之间的差异。结果支持拟议的新标准的有效性。

项目成果

期刊论文数量（29）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Neuropathology Education : A 52-year-old man with hypohydrosis

神经病理学教育：一名患有缺水症的 52 岁男性

DOI：
发表时间：
2006
期刊：
Neuropathology 26
影响因子：
0
作者：
Shimizu J;Hashimoto M;Murayama S;Tsuji S
通讯作者：
Tsuji S

Pathology of the sympathetic nervous system corresponding to the decreased cardiac uptake in (123) l-metaiodobenzylguanidine (MIBG) scintigraphy in a patient with Parkinson disease.

帕金森病患者 (123) L-间碘苄基胍 (MIBG) 闪烁扫描中心脏摄取减少所对应的交感神经系统病理学。

DOI：
发表时间：
2006
期刊：
J Neurol Sci. 25(Epub ahead of print)
影响因子：
0
作者：
Mitsui J;Saito Y;Momose T;Shimizu J;Arai N;Shibahara J;Ugawa Y;Kanazawa I;Tsuji S;Murayama S
通讯作者：
Murayama S

造血幹細胞移植後 GVHD(急性、慢性)に伴う末梢神経障害

造血干细胞移植后与 GVHD（急性、慢性）相关的周围神经病变