Study On Correlation Between Dermatomyositis/polymyositis And Malignancies

Dermatomyositis (DM) is a form of inflammatory connective tissue disorder that involves skeletal muscle and skin. Polymyositis (PM)refers to diseases of this group without skin damage. Dermatomyositis/Polymyositis associated with malignant tumor incidence is far higher than in other connective tissue diseases. It is recognized as a paraneoplastic syndrome in adults. The association between malignancy and DM/PM has been largely described and confirmed by numerous epidemiological studies. The objectives of this review are to investigate the correlativity between DM/PM and malignancies, further to understand the clinical features and pathogenesis of DM/PM, to guide the clinical therapy effectively and improve the prognosis, and to offer clue and help for early discovering, diagnosis and treatment of associated malignancies. Clinical data of 35cases dermatomyositis patients who hospitalized and consulted during 1990~2009 at the fourth hospital of HeBei Medical University and the pertinent literatures at home and abroad about this topic were retrospectively investigated and analyzed.Lots of research have indicated approximately 5~52% of DM/PM were complicated with malignancy. Through the summary dermatomyositis's cause, clinical classification and cardinal symptoms and so on, elaborated the situation of correlation between DM/PM and malignancy. This relationship and the issues that surround amyopathic dermatomyositis have remained controversial, so this review has not discussed in detail.Dermatomyositis/polymyositis affects both children and adults. The clinical appearance of a malignancy associated with DM/PM, in adult life, usually comes after age 40 years. The temporal relationship between the two pathologic conditions can vary: malignancy may occur before, at the same time or following the diagnosis of them. Most commonly cancer is diagnosed after the onset of DM/PM. The studies provide evidence that DM/PM are strongly associated with a wide range of cancers. Patients with DM have a greater risk of developing malignancy than the general population, while PM does seem to be associated to a lesser extent to an increased risk. DM and PM associated with tumor type is slightly different. The retrospective study has been demonstrated that the overall risk was highest during the first three years after the diagnosis of dermatomyositis/polymyositis, and that a trend towards a decreases risk of malignancy was observed with increasing time since diagnosis.Although clear evidence for a significant dermatomyositis-cancer association exists, optimal clinical or biological factors that predict an association with cancer have not been identified. Humoral and cellular immune are abnormal in DM/PM. Tumor tissue had cross antigenicity with normal muscle fibers, tendon sheath, blood vessels and connective tissue in vivo. Tumor antibodies can damage the normal tissues. The virus infections play an important role in the etiology of dermatomyositis/polymyositis and cancer. There is higher detection rate of EB virus in the dermatomyos -itis/polymyositis combined with nasopharyngeal carcinoma. Genetic susce- ptibility also one of the important reasons complicated with malignant tumors.The patients with manifestations of who are older than 40 years old, with an unhealthy redness, accompanied by system damage, poor response to glucocorticoids, with a serious throat or neck muscle involvement are at high risk associated with tumors. Abnormal elevation of serum CPK levels, erythrocyte sedimentation rate> 35 mm / 1 h in DM/PM patients often prompt the occurrence of cancer. Recently, some specific autoantibodies in dermatomyositis have been shown to be associated with internal malignancy. They open up the possibility to have available serological markers for detecting cancer-associated myositis in the near future. The treatment outcome of dermatomyositis/polymyositis was closely related to the prognosis and recurrence of malignancies. DM/PM is associated with high rates of malignancy and mortality. The majority of DM/PM patients with malignancy died during the study period of infection, pulmonary embolism, tumor spread and so on.The epidemiology investigation shows that in Asian patients, among whom nasopharyngeal cancer is more common, but in the euramerican countries take the ovarian cancer as the predominant types, this paper mainly describe the correlation between DM/PM and nasopharyngeal cancer, ovarian cancer.Continuous vigilance is required for early recognition, especially in older people and during the first 3 years after DM/PM onset. Since the chance for the presence of an occult cancer is particularly high in patients affected with DM/PM, these patients should be screened for underlying malignancy.