| ObjectivesThe objective of this study is to analysis clinical manifestations,assistant examination of dermatomyositis associated with malignant tumors in adult,explore the related factors in dermatomyositis with malignant tumor. MethodsTo collected date of 337 cases patients with DM of adult hospitalized and case data integrity in First Affiliated Hospital,Zhengzhou University from december 2012 to december 2015,all patients are from department of dermatology,oncology and internal medicine,Estabilshing the database of all DM patients by excel software, designing the data sheet,the retrospective investigation and record every patients' clinical massages about age,gender,course of the disease,clinical manifestation, complications,laboratory data,radiographic examination,treatment and so on.We found that 35 cases of 337 DM patients showed malignant tumor.We lay special stress on analysing the clinical manifestations,complications,laboratory and radiographic examination and treatment of the 35 cases diagnosed as dermatomyositis associated with malignant tumors.Meanwhile, we compared the clinical features and laboratory data between dermatomyositis associated with malignant tumors group and 302 patients without malignant tumors in DM.Statistical methods using SPSS22.0 statistical software, count data by chi-square test,the measurement datas by the t examination,and the statistical significance is designated at P < 0.05 by bilateral P examination. Results1 Among 337 cases patients with DM,with malignant tumors was 35 cases,the rate was 10.3%.2 Group of 35 cases of dermatomyositis associated with malignant tumors,female and male patients with ratio of 1:1.19.Age between 21 and 73,mean age 52.79±12.36 years old,41-50 y of these patients were most(34.28%).Group of 302 cases of dermatomyositis,female and male patients with ratio of 2.43:1.Age between 19 and 79,mean age 44.98±14.90.3 The incidence of malignant tumor in male patients with dermatomyositis(17.76%) was higher than that in female(8.26%)(P=0.02),but the incidence of DM is higher in women than in men,female and male patients with ratio of 2.15:1.4 We found 14 types of malignant tumors in 35 cases patients with dermatomyositis and malignant tumor,7 cases of lung cancer(male 4, female 3)(20%),6 cases of gastric carcinoma(all men)(17.14%),4 cases of breast cancer 4(11.42%),each 3 case of ovarian carcinoma, and thymic carcinoma,each 3 case of cervical cancer and nasopharyngeal carcinoma(8.57%),each 2 case of endometrial cancer, leukemia and lymphoma and thyroid carcinoma(5.71%), prostate cancer, liver cancer and tongue cancer(2.86%).5 In 35 patients with dermatomyositis and tumor,diagnosis of malignant tumor range DM before 14 years to DM after 3 years.6 21 cases patients of malignant tumors were occurred after the diagnosis of dermatomyositis(60%),among them,13 cases(37.14%) within first years,5 cases(14.29%) within second years,3 cases(8.57%) within third years. Among them,23 cases(65.71%)of malignant tumors were found in 1 years before and after the diagnosis of DM.7 Malignant erythema,dysphagia,ESR higher than 35mm/h and conventional treatment response difference happened more in dermatomyositis associated with malignant than the grorup without malignant tumors in DM.(P<0.05).8 The incidence of interstitial lung disease and anti Jo-1 antibody positive,dermatomyositis tumor group was significantly lower than that in patients without tumor group of dermatomyositis.(P<0.05) Conclusions1 DM can be associated with a variety of malignant tumors,the most common were lung cancer, gastric cancer, breast cancer.2 DM patients with malignant erythema,dysphagia,ESR increased significantly, respond poorly for clinical treatment,we should be alert to the occurrence of malignant tumor.3 Interstitial lung disease and antiJ0-1 antibody positive, may reduce the risk of malignant tumor in patients with DM... |
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