皮肌炎及多发性肌炎伴恶性肿瘤13例临床分析

目的：分析皮肌炎及多发性肌炎伴发恶性肿瘤患者的临床情况。方法：回顾性分析我院2002年至2009年8年间13例皮肌炎及多发性肌炎伴发恶性肿瘤患者,分析其临床表现、实验室辅助检查指标和治疗情况。结果：77例皮肌炎及多发性肌炎患者中16.88%（13/77）伴发恶性肿瘤,伴发的肿瘤主要为鼻咽癌、肺癌、胃癌,其中鼻咽癌占30.76%。伴发肿瘤的相关因素包括炎性肌病的发病年龄〉40岁的男性患者,甲周红斑、GLB升高〉35g/l,而合并肺间质纤维化的炎性肌病患者较少合并恶性肿瘤。结论：皮肌炎及多发性肌炎常伴发恶性肿瘤,所伴发肿瘤的类型广泛,但以鼻咽癌常见。对出现甲周红斑等皮肤血管炎表现年龄大于40岁的的男性皮肌炎及多发性肌炎者尤其在发病1~2年内应警惕伴发恶性肿瘤。

Analyzing 13 Cases Dermatomyositis and Polymyositis ssociated with Malignancy

Objective： To investigate the clinical features of dermatomyositis and polymyositis associated with malignancy.Method：A retrospective study was performed in patients with dermatomyositis and polymyositis associated with malignancy admitted to our hospital.The clinical manifestations,laboratory and auxiliary examination data,and treatment of those cases were analyzed.Result： Among 77 patients with dermatomyositis and polymyositis,the incidence of ma1ignancy was 16.88%（13/77）.of the 13 patients with malignancy,the most common malignancies were nasopharyngeal carcinoma,lung cancer and gastric carcinoma,and 30.76%cancers were diagnosed as nasopharyngeal carcinoma.There were some interrelated factors of inflammatory myopathy with malignancy including the onset in older age（40 years）,male,the periungual erythema,and GLB 35g/l.And those cases with inflammatory myopathy associated with pulmonary fibrosis were less associated with malignancy.Conclusion：These results provide evidence that dermatomyositis and polymyositis are frequently associated with a wide variety of cancers,particularly nasopharyngeal carcinoma.Male DM/PM patients over 40 years of age or with a periungual erythema should be screened for possible associated malignancy,especially within 1 to 2 years from onset.