Document Detail


Predicting factors of malignancy in dermatomyositis and polymyositis: a case-control study.
MedLine Citation:
PMID:  11298544     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: An association between dermatomyositis (DM)/polymyositis (PM) and malignancies has been widely reported in the literature. The validity of extensive evaluation for malignancies in those patients has also been questioned for decades. Only limited papers regarding the signs of malignancy and the prognostic factors in DM/PM have been reported. OBJECTIVES: To define the potential risk factors of concomitant neoplastic diseases in patients diagnosed as having DM/PM. METHODS: From 1 April 1983 to 30 June 1999, 147 patients were diagnosed as having probable or definite DM/PM at the Veterans General Hospital, Taichung, Taiwan. We excluded four patients who had preceding neoplastic diseases diagnosed before DM/PM, then retrospectively reviewed the data of the remaining 143 patients and subgrouped the cases as four main types: primary idiopathic DM, primary idiopathic PM, juvenile DM/PM and amyopathic DM (ADM). We next performed univariate analysis using logistic regression to evaluate the possible predictive factors for malignancies, such as mean age at onset, gender, manifestations at onset, association with other connective tissue diseases, initial skin presentations, complications and laboratory data. Then we chose the significant factors for multivariate analysis by logistic regression, to determine the independent risk factors of malignancies in DM/PM patients. RESULTS: Among the 143 patients, DM was the most common type (64%), followed by ADM (14%), juvenile DM/PM (13%) and PM (10%). The mean age at onset overall was 42.4 years. Other connective tissue diseases were present in 22% of all patients, especially PM (50%) and juvenile DM/PM patients (28%). Internal malignancies were present in 13% of patients, and most were associated with DM. Nasopharyngeal carcinomas (NPCs) were the most common tumours. Patients with primary idiopathic DM, with an older age at onset, higher serum creatine phosphokinase levels and male gender, had more chance of developing concomitant malignancies. Those associated with complications, especially interstitial lung diseases, had a lower risk of associated neoplasia. In multivariate analysis, an older age at onset (odds ratio 9.10) and male gender (odds ratio 4.06) were associated with greater risk of developing malignancies. CONCLUSIONS: The two independent predictive factors for malignancy (P < 0.05) in patients with DM/PM were an older age at onset (> 45 years) and male gender. The primary idiopathic DM group was shown to have higher risk of developing internal malignancies, especially NPC. However, this was not identified as an independent predictive factor for concomitant neoplastic diseases in multivariate analysis. In addition, patients who had the complication of interstitial lung disease had a significantly lower frequency of malignancies (P < 0.001).
Authors:
Y J Chen; C Y Wu; J L Shen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of dermatology     Volume:  144     ISSN:  0007-0963     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-12     Completed Date:  2001-05-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  825-31     Citation Subset:  IM    
Affiliation:
Department of Dermatology, Taichung Veterans General Hospital, no. 160, Sec. 3, Taichung-Kang Road, Taichung, Taiwan China Medical College, Taichung, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age of Onset
Analysis of Variance
Autoimmune Diseases / complications
Case-Control Studies
Child
Connective Tissue Diseases / complications
Dermatomyositis / etiology*
Female
Humans
Male
Middle Aged
Multivariate Analysis
Nasopharyngeal Neoplasms / complications
Neoplasms / complications*
Paraneoplastic Syndromes / etiology*
Prognosis
Retrospective Studies
Risk Factors
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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