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Abstract：
To identify clinical factors associated with cancer risk in the idiopathic inflammatory myopathies (IIMs) and to systematically review the existing evidence related to cancer screening.
A systematic literature search was carried out on Medline, Embase and Scopus. Cancer risk within the IIM population (i.e. not compared with the general population) was expressed as risk ratios (RR) for binary variables and weighted mean differences (WMD) for continuous variables. Evidence relating to cancer screening practices in the IIMs were synthesized via narrative review.
Sixty-nine studies were included in the meta-analysis. DM subtype (RR 2.21), older age (WMD 11.19), male sex (RR 1.53), dysphagia (RR 2.09), cutaneous ulceration (RR 2.73) and anti-transcriptional intermediary factor-1 gamma positivity (RR 4.66) were identified as being associated with significantly increased risk of cancer. PM (RR 0.49) and clinically amyopathic DM (RR 0.44) subtypes, Raynaud\'s phenomenon (RR 0.61), interstitial lung disease (RR 0.49), very high serum creatine kinase (WMD -1189.96) or lactate dehydrogenase (WMD -336.52) levels, and anti-Jo1 (RR 0.45) or anti-EJ (RR 0.17) positivity were identified as being associated with significantly reduced risk of cancer. Nine studies relating to IIM-specific cancer screening were included. CT scanning of the thorax, abdomen and pelvis appeared to be effective in identifying underlying asymptomatic cancers.
Cancer risk factors should be evaluated in patients with IIM for risk stratification. Screening evidence is limited but CT scanning could be useful. Prospective studies and consensus guidelines are needed to establish cancer screening strategies in IIM patients.
A systematic literature search was carried out on Medline, Embase and Scopus. Cancer risk within the IIM population (i.e. not compared with the general population) was expressed as risk ratios (RR) for binary variables and weighted mean differences (WMD) for continuous variables. Evidence relating to cancer screening practices in the IIMs were synthesized via narrative review.
Sixty-nine studies were included in the meta-analysis. DM subtype (RR 2.21), older age (WMD 11.19), male sex (RR 1.53), dysphagia (RR 2.09), cutaneous ulceration (RR 2.73) and anti-transcriptional intermediary factor-1 gamma positivity (RR 4.66) were identified as being associated with significantly increased risk of cancer. PM (RR 0.49) and clinically amyopathic DM (RR 0.44) subtypes, Raynaud\'s phenomenon (RR 0.61), interstitial lung disease (RR 0.49), very high serum creatine kinase (WMD -1189.96) or lactate dehydrogenase (WMD -336.52) levels, and anti-Jo1 (RR 0.45) or anti-EJ (RR 0.17) positivity were identified as being associated with significantly reduced risk of cancer. Nine studies relating to IIM-specific cancer screening were included. CT scanning of the thorax, abdomen and pelvis appeared to be effective in identifying underlying asymptomatic cancers.
Cancer risk factors should be evaluated in patients with IIM for risk stratification. Screening evidence is limited but CT scanning could be useful. Prospective studies and consensus guidelines are needed to establish cancer screening strategies in IIM patients.
摘要：
探讨特发性炎症性肌病(IIMs)患者与癌症风险相关的临床因素，并系统评价现有癌症筛查相关证据。
在Medline上进行了系统的文献检索，Embase和Scopus。IIM人群中的癌症风险（即未与普通人群进行比较）表示为二元变量的风险比（RR）和连续变量的加权平均差（WMD）。通过叙述性综述综合了与IIM中癌症筛查实践有关的证据。
69项研究纳入荟萃分析。DM亚型（RR2.21），年龄较大(大规模杀伤性武器11.19)，男性（RR1.53），吞咽困难（RR2.09），发现皮肤溃疡(RR2.73)和抗转录中介因子-1γ阳性(RR4.66)与癌症风险显著增加相关.PM（RR0.49）和临床无肌病性DM（RR0.44）亚型，雷诺现象(RR0.61)，间质性肺病（RR0.49），非常高的血清肌酸激酶（WMD-1189.96）或乳酸脱氢酶（WMD-336.52）水平，抗Jo1（RR0.45）或抗EJ（RR0.17）阳性被确定为与癌症风险显着降低相关。包括与IIM特异性癌症筛查有关的9项研究。胸部CT扫描,腹部和骨盆在识别潜在的无症状癌症方面似乎是有效的。
应评估IIM患者的癌症危险因素以进行危险分层。筛查证据有限，但CT扫描可能有用。需要前瞻性研究和共识指南来建立IIM患者的癌症筛查策略。
在Medline上进行了系统的文献检索，Embase和Scopus。IIM人群中的癌症风险（即未与普通人群进行比较）表示为二元变量的风险比（RR）和连续变量的加权平均差（WMD）。通过叙述性综述综合了与IIM中癌症筛查实践有关的证据。
69项研究纳入荟萃分析。DM亚型（RR2.21），年龄较大(大规模杀伤性武器11.19)，男性（RR1.53），吞咽困难（RR2.09），发现皮肤溃疡(RR2.73)和抗转录中介因子-1γ阳性(RR4.66)与癌症风险显著增加相关.PM（RR0.49）和临床无肌病性DM（RR0.44）亚型，雷诺现象(RR0.61)，间质性肺病（RR0.49），非常高的血清肌酸激酶（WMD-1189.96）或乳酸脱氢酶（WMD-336.52）水平，抗Jo1（RR0.45）或抗EJ（RR0.17）阳性被确定为与癌症风险显着降低相关。包括与IIM特异性癌症筛查有关的9项研究。胸部CT扫描,腹部和骨盆在识别潜在的无症状癌症方面似乎是有效的。
应评估IIM患者的癌症危险因素以进行危险分层。筛查证据有限，但CT扫描可能有用。需要前瞻性研究和共识指南来建立IIM患者的癌症筛查策略。
