诊断学理论与实践 ›› 2020, Vol. 19 ›› Issue (03): 274-278.doi: 10.16150/j.1671-2870.2020.03.013

• 论著 • 上一篇    下一篇

抗转录中介因子1-γ抗体是成人皮肌炎合并恶性肿瘤的血清学标志物

夏群力a, 刁立诚a, 吴海曦a, 薛珂a, 吴丹a, 杜联军b, 郑捷a, 曹华a(), 黎皓c()   

  1. 上海交通大学医学院附属瑞金医院a. 皮肤科,b. 放射科,c. 肿瘤科,上海 200025
  • 收稿日期:2020-04-03 出版日期:2020-06-25 发布日期:2020-06-25
  • 通讯作者: 曹华,黎皓 E-mail:drcaohua@126.com;drlihao@126.com
  • 基金资助:
    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);国家自然科学基金面上项目(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)

Anti-transcriptional intermediary factor 1-γ antibody serves as a serum biomarker for dermatomyositis accompanied by malignancy diseases

XIA Qunlia, DIAO Lichenga, WU Haixia, XUE Kea, WU Dana, DU Lianjunb, ZHENG Jiea, CAO Huaa(), LI Haoc()   

  1. Department of Dermatology, b. Department of Radiology, c. Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2020-04-03 Online:2020-06-25 Published:2020-06-25
  • Contact: CAO Hua,LI Hao E-mail:drcaohua@126.com;drlihao@126.com

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<0.000 1];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<0.000 1]。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患者需要加强恶性肿瘤筛查。

关键词: 皮肌炎, 转录中介因子1-γ, 肿瘤

Abstract:

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 juvenile 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 anti-TIF1-γ antibodies in patients at first visit. The positive rates of anti-TIF1-γ antibody 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-γ antibody detected, including 36 cased of DM (33.6%) and 38 cases of CADM (37.3%). Serum anti-TIF1-γ antibody was positive in 3 cases of JCADM (33.3%), but none in total of 5 cases of JDM. The positive rate of anti-TIF1-γ antibody in DM patients with malignant tumor was significantly higher than those without malignant tumor[26/35(74.3%) vs 10/72(13.9%), P<0.000 1]. The incidence of malignant tumor in patients with positive anti-TIF1-γ antibody was significantly higher than those with negative antibody[26/36(72.2%) vs 9/71(12.7%), P<0.000 1]. However there was no significant difference in the positive rate of anti-TIF1-γ antibody 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-TIF1-γ antibody-positive and antibody-negative patients[4/38 (10.5%) vs 3/64(4.7%), P=0.420]. Conclusions: Serum anti-TIF1-γ antibody correlates with the occurrence of malignancy diseases in DM, but has no relationship with malignancy diseases in CADM. Thus, anti-TIF1-γ antibody might be the serum biomarker for DM associated with malignancy, and oncology screening should be intensified in adult DM patients with positive anti-TIF1-γ antibody.

Key words: Dermatomyositis, Transcriptional intermediary factor 1-γ, Malignancy

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