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引用次数: 0
摘要
本章回顾了癌症与特发性炎症性肌病（IIM）之间的关系，IIM包括皮肌炎（DM）、抗肌酸激酶综合征（ASyS）、免疫介导的坏死性肌病（IMNM）和包涵体肌炎（IBM）。越来越多的证据表明，DM 患者并发恶性肿瘤的风险很高，尤其是在抗 Tif1γ 自身抗体患者中。没有明确自身抗体的 IMNM 患者罹患恶性肿瘤的风险也会增加。最近的证据表明，许多 IBM 患者的循环 CD57+ CD8+ T 细胞数量增加，这与大颗粒淋巴细胞白血病的诊断一致。相比之下，IMNM 患者中的抗-SRP 或抗-HMGCR 自身抗体以及 ASyS 综合征患者患癌症的风险并没有明确增加。接受免疫检查点抑制剂治疗的癌症患者可能会患上肌炎（ICI-肌炎），有时还会伴有重症肌无力和/或心肌炎。
This chapter reviews the association between cancer and the idiopathic inflammatory myopathies (IIM), which includes dermatomyositis (DM), antisynthetase syndrome (ASyS), immune-mediated necrotizing myopathy (IMNM), and inclusion body myositis (IBM). Accumulating evidence shows that the risk of a coexisting malignancy is high in patients with DM, especially among those with anti-Tif1γ autoantibodies. Patients with IMNM and no defined autoantibodies also have an increased risk of malignancy. Recent evidence demonstrates that many IBM patients have increased numbers of circulating CD57+ CD8+ T cells, consistent with a diagnosis of large granular lymphocytic leukemia. In contrast, IMNM patients with anti-SRP or anti-HMGCR autoantibodies as well as patients with ASyS syndrome do not have a definitively increased risk of cancer. Patients who have a cancer treated with one of the immune checkpoint inhibitors can develop myositis (ICI-myositis), sometimes along with myasthenia gravis and/or myocarditis.
期刊介绍：
The Handbook of Clinical Neurology (HCN) was originally conceived and edited by Pierre Vinken and George Bruyn as a prestigious, multivolume reference work that would cover all the disorders encountered by clinicians and researchers engaged in neurology and allied fields. The first series of the Handbook (Volumes 1-44) was published between 1968 and 1982 and was followed by a second series (Volumes 45-78), guided by the same editors, which concluded in 2002. By that time, the Handbook had come to represent one of the largest scientific works ever published. In 2002, Professors Michael J. Aminoff, François Boller, and Dick F. Swaab took on the responsibility of supervising the third (current) series, the first volumes of which published in 2003. They have designed this series to encompass both clinical neurology and also the basic and clinical neurosciences that are its underpinning. Given the enormity and complexity of the accumulating literature, it is almost impossible to keep abreast of developments in the field, thus providing the raison d''être for the series. The series will thus appeal to clinicians and investigators alike, providing to each an added dimension. Now, more than 140 volumes after it began, the Handbook of Clinical Neurology series has an unparalleled reputation for providing the latest information on fundamental research on the operation of the nervous system in health and disease, comprehensive clinical information on neurological and related disorders, and up-to-date treatment protocols.
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