Factors Predicting Malignancy in Patients with Polymyositis and Dermatomyostis: A Systematic Review and Meta-Analysis

Lü, Xin; Yang, Hanbo; Shu, Xi; Chen, Fang; Zhang, Yinli; Zhang, Sigong; Peng, Qinglin; Tian, Xiaowen; Wang, Guochun

doi:10.1371/journal.pone.0094128

Cited by 102 publications

(118 citation statements)

References 59 publications

(167 reference statements)

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“…The risk is maximal within the first year of follow-up and in Asian populations, and is higher in cases of severe dermatomyositis rash suggestive of intense vasculitis (cutaneous ulcers and periungual erythema), older age, male sex, higher C-reactive protein, elevated erythrocyte sedimentation rate and dysphagia [156,160,161]. Conversely, the frequency of cancer is lower among patients with anti-extractable nuclear antigen autoantibodies, anti-Jo1 autoantibodies and corresponding clinical features (ILD, Raynaud's phenomenon and arthralgia) [47,160], but these findings cannot allow CAM to be ruled out [63].…”

Section: Malignancymentioning

confidence: 99%

Idiopathic inflammatory myopathies and the lung

et al. 2015

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Idiopathic inflammatory myositis (IIM) is a group of rare connective tissue diseases (CTDs) characterised by muscular and extramuscular signs, in which lung involvement is a challenging issue. Interstitial lung disease (ILD) is the hallmark of pulmonary involvement in IIM, and causes morbidity and mortality, resulting in an estimated excess mortality of 50% in some series. Except for inclusion body myositis, these extrapulmonary disorders are associated with the general and visceral involvement frequently found in other CTDs including fever, Raynaud's phenomenon, arthralgia, nonspecific cutaneous modifications and ILD, for which the prevalence is estimated to be up to 65%. Substantial heterogeneity exists within the spectrum of IIMs, and each condition is associated with various frequencies and subtypes of pulmonary involvement. This heterogeneity is partly related to the presence of various autoantibodies encompassing anti-synthetase, anti-MDA5 and anti-PM/Scl. ILD is present in all subsets of IIM including juvenile myositis, but is more frequent in dermatomyositis and overlap myositis. IIM can also be associated with other presentations of respiratory involvement, namely pulmonary arterial hypertension, pleural disease, infections, drug-induced toxicity, malignancy and respiratory muscle weakness. Here, we critically review the current knowledge about adult and juvenile myositis-associated lung disease with a detailed description of therapeutics for chronic and rapidly progressive ILD. @ERSpublications Interstitial lung disease is a leading cause of morbidity in dermatomyositis/polymyositis

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Section: Malignancymentioning

confidence: 99%

Idiopathic inflammatory myopathies and the lung

et al. 2015

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“…Increased risk of malignancy is associated with elevated serum creatine kinase (CK) levels as well as a rapid onset of disease, defined as less than 4 months between symptom onset and diagnosis [33,41]. High levels of inflammatory markers (erythrocyte sedimentation rate and C-reactive protein) were also seen more frequently in patients subsequently diagnosed with cancer.…”

Section: Risk Factors For Malignancy In Patients With Iimmentioning

confidence: 99%

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review

Tiniakou

Mammen

2015

Clinic Rev Allerg Immunol

106

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The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of autoimmune diseases (collectively known as myositis) affecting the skeletal muscles as well as other organ systems such as skin, lungs, and joints. The primary forms of myositis include polymyositis (PM), dermatomyositis (PM), and immune-mediated necrotizing myopathy (IMNM). Patients with these diseases experience progressive proximal muscle weakness, have characteristic muscle biopsy findings, and produce autoantibodies that are associated with unique clinical features. One distinguishing feature of these patients is that they are also known to have an increased risk of cancer. Since the first description of the association in 1916, it has been extensively reported in the medical literature. However, there have been significant variations between the different studies with regard to the degree of cancer risk in patients with IIM. These discrepancies can, in part, be attributed to differences in the definition of malignancy-associated myositis used in different studies. In recent years, significant advances have been made in defining specific features of IIM that are associated with the development of malignancy. One of these has been myositis-specific antibodies (MSAs), which are linked to distinct clinical phenotypes and categorize patients into groups with more homogeneous features. Indeed, patients with certain MSAs seem to be at particularly increased risk of malignancy. This review attempts a systematic evaluation of research regarding the association between malignancy and myositis.

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“…The association between IMs, particularly DM, and malignancy has been well described (9)(10)(11)(12)(13)(14). According to the first meta-analysis conducted to preliminarily confirm this association, malignancy was found to occur in 25% and 10-15% of adult patients with DM and PM, respectively, within 0-5 years of disease onset (15).…”

Section: Introductionmentioning

confidence: 94%

Gene Expression Profile of Inflammatory Myopathy with Malignancy is Similar to that of Dermatomyositis rather than Polymyositis

et al. 2016

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Objective An association has been reported between inflammatory myopathies (IMs), which include polymyositis (PM) and dermatomyositis (DM), and malignancy, and the concept of cancer-associated myositis (CAM) was recently proposed. We herein attempted to determine the features and etiologies of these myopathies. Methods We analyzed the gene expression levels via microarray and real-time quantitative reverse transcription polymerase chain reaction analyses to identify genes that were specifically upregulated or downregulated with suspected inflammatory involvement and verified the microarray data via an immunohistochemical (IHC) analysis in additional cases. Patients We selected 14 patients with the following conditions: PM without malignancy (n=3), DM without malignancy (n=3), CAM (n=3), and Controls (no pathological changes or malignancy; n=5). Results PM was distinct from DM and CAM in a clustering analysis and exhibited the highest numbers of overexpressed genes and specific pathologies in a gene ontology analysis. The IHC analysis confirmed the gene expression results. Conclusion PM is associated with severe inflammatory pathological findings, primarily in the cell-mediated immune system. DM and CAM exhibit similarities in the gene expression and IHC results, which suggest that humoral immunity is the main etiology for both myopathies, indicating the importance of cancer screening in patients with IMs, particularly DM.

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Factors Predicting Malignancy in Patients with Polymyositis and Dermatomyostis: A Systematic Review and Meta-Analysis

Cited by 102 publications

References 59 publications

Idiopathic inflammatory myopathies and the lung

Idiopathic inflammatory myopathies and the lung

Idiopathic Inflammatory Myopathies and Malignancy: a Comprehensive Review

Gene Expression Profile of Inflammatory Myopathy with Malignancy is Similar to that of Dermatomyositis rather than Polymyositis

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