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多发性肌炎合并恶性肿瘤10例临床特点

徐娜 焦洋 曾学军 张奉春

徐娜, 焦洋, 曾学军, 张奉春. 多发性肌炎合并恶性肿瘤10例临床特点[J]. 协和医学杂志, 2015, 6(1): 24-28. doi: 10.3969/j.issn.1674-9081.2015.01.005
引用本文: 徐娜, 焦洋, 曾学军, 张奉春. 多发性肌炎合并恶性肿瘤10例临床特点[J]. 协和医学杂志, 2015, 6(1): 24-28. doi: 10.3969/j.issn.1674-9081.2015.01.005
Na XV, Yang JIAO, Xue-jun ZENG, Feng-chun ZHANG. Clinical Characteristics of 10 Cases with Polymyositis and Malignancy[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(1): 24-28. doi: 10.3969/j.issn.1674-9081.2015.01.005
Citation: Na XV, Yang JIAO, Xue-jun ZENG, Feng-chun ZHANG. Clinical Characteristics of 10 Cases with Polymyositis and Malignancy[J]. Medical Journal of Peking Union Medical College Hospital, 2015, 6(1): 24-28. doi: 10.3969/j.issn.1674-9081.2015.01.005

多发性肌炎合并恶性肿瘤10例临床特点

doi: 10.3969/j.issn.1674-9081.2015.01.005
详细信息
    通讯作者:

    焦洋 电话:010-69158221, E-mail:peterpumch@163.com

  • 中图分类号: R593.2

Clinical Characteristics of 10 Cases with Polymyositis and Malignancy

More Information
  • 摘要:   目的  总结多发性肌炎(polymyositis, PM)合并恶性肿瘤患者的临床特点。  方法  回顾性分析1989年10月至2013年6月在北京协和医院住院的PM合并恶性肿瘤患者的临床资料, 总结其临床特点。  结果  PM合并恶性肿瘤患者共10例, 占同期PM住院患者的2.4%(10/424)。其中男3例, 女7例, 中位年龄57岁。所有患者均有四肢近端肌无力; 抬头困难、饮水呛咳、声音嘶哑各1例。出现肺间质病变5例、呼吸肌受累2例、心脏受累6例。肿瘤类型以淋巴瘤和肺癌常见(各3例), 其他包括食管癌、胃癌、肾癌、宫颈癌(各1例)。7例患者在PM诊断前后1年内发现肿瘤, 肿瘤首发表现包括淋巴结肿大、咳嗽气短、吞咽困难、肉眼血尿、绝经后阴道流血, 3例无症状患者筛查发现便潜血阳性或肺占位。9例接受足量激素治疗, 5例PM在1个月内完全缓解; 4例仅部分缓解, 其中3例在肿瘤治疗后完全缓解。  结论  由于合并恶性肿瘤可影响PM的治疗反应和预后, 临床应高度警惕。对于PM合并肿瘤患者, 应及早进行肿瘤治疗以更好地改善症状和控制病情。
  • 表  1  10例PM合并恶性肿瘤患者临床基本情况、治疗方案与预后

    病例 性别 年龄
    (岁)
    肿瘤
    类型
    肿瘤首发表现 血CK峰值
    (U/L)
    ILD 呼吸肌
    受累
    心脏
    受累
    PM治疗 肿瘤治疗 PM预后
    1 20 淋巴瘤 淋巴结肿大 831 激素+CTX 化疗 缓解
    2 29 淋巴瘤 淋巴结肿大 2319 激素+CTX 化疗 缓解
    3 48 淋巴瘤 淋巴结肿大 224 激素+MTX 化疗 缓解
    4 62 宫颈癌 绝经后阴道流血 754 激素+MTX 手术+化疗 缓解
    5 57 肺癌 CT发现肺占位 11 541 激素 手术 缓解
    6 69 肺癌 咳嗽气短 1362 激素+CTX 手术+化疗 缓解
    7 56 食管癌 吞咽困难 624 激素 手术 缓解
    8 73 胃癌 便潜血阳性 849 激素+CTX 化疗 缓解
    9 77 肾癌 肉眼血尿 1069 激素+MTX 放弃手术 部分缓解
    10 74 肺癌 CT发现肺占位 4338 拒绝激素 放弃手术 无改善
    PM:多发性肌炎;CK:肌酸激酶;ILD:间质性肺疾病;CTX:环磷酰胺;MTX:氨甲蝶呤
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  • 收稿日期:  2014-02-28
  • 刊出日期:  2015-01-30

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