İdiyopatik inflamatuar miyopatili hastaların klinik, histopatolojik özellikleri ve malignite sıklığı

Year 2024, Volume: 49 Issue: 2, 314 - 319, 30.06.2024

Elif Altunel Kılınç , Zeynep Tüzün , Gizem Kırmızıer , Gizem Varkal , İpek Türk , Didem Arslan , Hüseyin Turgut Elbek Özer , Süleyman Özbek

https://doi.org/10.17826/cumj.1412123

Abstract

Amaç: İdiyopatik inflamatuar miyopati (İİM) grubu hastalıklar kanser ile güçlü bir şekilde ilişkilidir. Bu çalışmada kliniğimizde tanı konulan İİM hastalarının klinik ve histopatolojik özelliklerinin tanımlanması, eşlik eden malignitelerin sıklığı ve alt tiplerinin değerlendirilmesi ve patolojik boyanma paternleri ile İİM alt grupları arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Bu retrospektif çalışmaya 2010-2023 yılları arasında İİM tanısı konan ve tanı anında kas biyopsisi yapılan 74 hasta dahil edilmiştir. Yaş, cinsiyet, görüntüleme, elektromiyografi ve kas biyopsisi sonuçları hastanenin elektronik sistemi kullanılarak elde edildi.
Bulgular: İİM'li 74 hastanın 45'i polimiyozit (PM), 27'si dermatomiyozit (DM) ve ikisi inklüzyon cisimciği miyozitidir (İCM). İİM'li 74 hastanın 12'sinde (%16) malignite gelişti, bunların ikisinde (%16,6) İİM tanısından önce malignite vardı (bir meme kanseri, bir tiroid papiller kanseri). PM grubunda beş hastada (%41,6) (en sık meme kanseri), DM grubunda beş hastada (%41,6) (en sık endometriyal kanser) ve İCM grubunda iki hastada (%16,8) malignite tanısı konmuştur. Membran atak kompleksi ile pozitif boyanmanın DM grubunda PM grubuna kıyasla daha yüksek olduğu bulunmuştur.
Sonuç: Bu sonuçlar, İİM hastalarında kanser taramasının düzenli aralıklarla yapılması gerektiğini göstermektedir. Kadın hastalarda meme ve endometriyal kanser taramasına ve erkek hastalarda akciğer kanseri taramasına özel önem verilmelidir. Patolojik boyama modelleri ile İİM alt tipleri arasındaki ilişkiyi açıklamak için geniş kohort çalışmalarına ihtiyaç vardır.

Keywords

Polimiyozit, dermatomiyozit, inklüzyon cisimcikli miyozit, membran atak kompleksi, malignite

Clinical, histopathological features and malignancy frequency of patients with idiopathic inflammatory myopathy

Abstract

Purpose: Idiopathic inflammatory myopathy (IIM) group diseases are strongly linked to cancer. This study aims to describe the clinical and histopathological features of IIM patients diagnosed in our clinic, evaluate the frequency and subtypes of accompanying malignancies, and examine the relationship between pathological staining patterns and IIM subgroups.
Materials and Methods: This retrospective study included 74 patients with IIM diagnosed between 2010 and 2023 who had a muscle biopsy at the time of diagnosis. Age, gender, imaging, electromyography, and muscle biopsy results were obtained using the hospital's electronic system.
Results: Of the 74 patients with IIM, 45 are polymyositis (PM), 27 are dermatomyositis (DM) and two are inclusion body myositis (IBM). Malignancy developed in 12 (16%) of 74 IIMs, two (16.6%) of whom had malignancy before the diagnosis of IIM (one breast cancer, one thyroid papillary cancer). Malignancy was diagnosed in five patients (41.6%) in the PM group (the most common breast cancer), five patients (41.6%) in the DM group (the most common endometrial cancer, and two patients (16.8%) in the IBM group. It was found that positive staining with membrane attack complex was higher in the DM group compared to the PM group.
Conclusion: Cancer screening should be performed at regular intervals in IIM patients. Breast and endometrial cancer screening should be prioritized in female patients, as well as lung cancer screening in male patients. Large cohort studies are needed to explain the relationship between pathological staining patterns and IIM subtypes.

Keywords

polymyositis, dermatomyositis, inclusion body myositis, membrane attack complex, malignancy

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