摘要
目的:研究血清抗转录中介因子1-γ(transcriptional intermediary factor 1-γ,TIF1-γ)抗体在诊断皮肌炎(dermatomyositis,DM)和临床无肌病性皮肌炎(clinically amyopathic dermatomyositis,CADM)合并恶性肿瘤中的价值。方法:2016年1月至2019年12月间,收集上海交通大学医学院附属瑞金医院皮肤科病房收治的223例DM和CADM患者[包括209例成人DM(107例)和CADM(102例),5例青少年DM(juvenile DM,JDM)和9例青少年JCADM(juvenile CADM,JCADM)]的临床资料。成人DM和成人CADM分别被分为恶性肿瘤组和无肿瘤组。初诊时血清用酶联免疫吸附测定法检测患者血清抗TIF1-γ抗体,分别比较成人DM和成人CADM患者中恶性肿瘤与无肿瘤患者之间抗TIF1-γ抗体的阳性率,进一步比较抗TIF1-γ抗体阳性与抗体阴性患者之间恶性肿瘤的发生率。结果:①成人DM和CADM中恶性肿瘤共42例(20.1%),占前3位的分别是鼻咽癌、乳腺癌和肺癌。JDM和JCADM患者中无一例发生恶性肿瘤。②成人DM和CADM中有74例(74/209,35.4%)血清抗TIF1-γ抗体阳性,其中DM患者抗TIF1-γ抗体阳性率33.6%(36/107),CADM患者抗TIF1-γ抗体阳性率37.3%(38/102)。5例JDM患者中,无一例抗TIF1-γ抗体阳性;9例JCADM患者中,3例抗TIF1-γ抗体阳性。③成人DM中,恶性肿瘤患者的抗TIF1-γ抗体阳性率显著高于无肿瘤患者[26/35(74.3%)比10/72(13.9%),P<0.0001];抗TIF1-γ抗体阳性患者恶性肿瘤的发生率显著高于阴性患者[26/36(72.2%)比9/71(12.7%),P<0.0001]。成人CADM中,恶性肿瘤患者与无肿瘤患者之间抗TIF1-γ抗体的阳性率差异无统计学意义[4/7比34/95(35.8%),P=0.420];抗TIF1-γ抗体阳性与抗体阴性患者之间恶性肿瘤的发生率差异无统计学意义[4/38(10.5%)比3/64(4.7%),P=0.420]。结论:抗TIF1-γ抗体阳性与成人DM患者恶性肿瘤的发生相关,而与成人CADM患者恶性肿瘤发生无关。抗TIF1-γ抗体可能是成人DM合并恶性肿瘤的血清标志物,对于抗TIF1-γ抗体阳性的成人DM患�
Objective:To explore significance of anti-transcriptional intermediary factor 1-γ(TIF1-γ)antibody detection in diagnosing ermatomyositis(DM)malignancy or clinically amyopathic dermatomyositis(CADM)accompanied by malignancy diseases.Methods:A total of hospitalized 223 patients were enrolled at Department of Dermatology,Ruijin Hospital during Jan.2016 to Dec.2019,including 107 cases of adult DM,102 cases of adult CADM,5 cases of juve-nile DM,and 9 cases of juvenile CADM.DM patients were divided into malignant DM group and non-malignant DM group,and so were the CADM patients.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum antiTIF1-γantibodies in patients at first visit.The positive rates of anti-TIF1-γantibody were compared between malignant DM group and non-malignant DM as well as between malignant CADM group and non-malignant CADM group.Results:It revealed that 35 adult DM and 7 adult CADM patients were diagnosed as having malignant neoplasia,and nasopharyngeal carcinoma,breast cancer and lung cancer were on the top three of cancer-associated myositis in our cohort,however,there was no malignancy detected in JDM and JCADM patients.Seventy-four(35.4%)adult patients had serum anti-TIF1-γantibody detected,including 36 cased of DM(33.6%)and 38 cases of CADM(37.3%).Serum antiTIF1-γantibody was positive in 3 cases of JCADM(33.3%),but none in total of 5 cases of JDM.The positive rate of anti-TIF1-γantibody in DM patients with malignant tumor was significantly higher than those without malignant tumor[26/35(74.3%)vs 10/72(13.9%),P<0.0001].The incidence of malignant tumor in patients with positive anti-TIF1-γantibody was significantly higher than those with negative antibody[26/36(72.2%)vs 9/71(12.7%),P<0.0001].However there was no significant difference in the positive rate of anti-TIF1-γantibody between patients with malignant tumor and without malignant tumor[4/7 vs 34/95(35.8%),P=0.420]in adult CADM.There was no statistically significant difference in the incidence of malignancy between anti-T
作者
夏群力
刁立诚
吴海曦
薛珂
吴丹
杜联军
郑捷
曹华
黎皓
XIA Qunli;DIAO Licheng;WU Haixi;XUE Ke;WU Dan;DU Lianjun;ZHENG Jie;CAO Hua;LI Hao(Department of Dermatology,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Radiology,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Oncology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《诊断学理论与实践》
2020年第3期274-278,共5页
Journal of Diagnostics Concepts & Practice
基金
CSCO-默克雪兰诺肿瘤研究基金(SCOREY-MX2015-045)
国家自然科学基金面上项目(81573037,81872523)
上海市科委医学引导类项目(134119a6100)
上海申康医院发展中心临床创新三年行动计划(16CR3084B)
上海交通大学医学院高峰学科——临床医学研究型医师(20172009)。
关键词
皮肌炎
转录中介因子1-γ
肿瘤
Dermatomyositis
Transcriptional intermediary factor 1-γ
Malignancy
