自身免疫性疾病合并恶性肿瘤17例分析

目的总结自身免疫性疾病并发恶性肿瘤临床表现。方法回顾性分析1997年6月至2006年6月在我科住院的所有患者,选取其中并发恶性肿瘤的患者进行分析。结果自身免疫性疾病并发恶性肿瘤共17例,其中多发性肌炎/皮肌炎并发肿瘤9例,类风湿性关节炎并发肿瘤3例,系统性红斑狼疮并发肿瘤2例,强直性脊柱炎、银屑病关节炎、原发性小血管炎并发肿瘤各1例,恶性肿瘤包括鼻咽癌5例,乳腺癌5例,肺癌4例,肝癌、肾癌、多发性骨髓瘤各1例。经正规治疗,只有3例患者红细胞沉降率完全回复正常水平,其余14例只有轻度下降。结论自身免疫性疾病容易合并恶性肿瘤,其中以多发性肌炎、皮肌炎最易并发,对经正规治疗后红细胞沉降率无明显下降的患者要排除有无肿瘤。

Autoimmune diseases complicated by malignancy: a case report of 17 patients

Objective To investigate the clinical features of autoimmune diseases complicated by malignancy.Methods Data of patients with autoimmune diseases complicated by malignancy treated in our department from Jun.1997 to Jun.2006 were analysed retrospectively.Results Seventeen patients with autoimmune diseases were found to have a wide range of malignancy,including nasopharyngeal carcinoma(5),breast cancer(5),lung cancer(4),hepatocarcinoma(1),renal carcinoma(1) and multiple myeloma(1).Six kinds of autoimmune diseases were complicated by malignancy,they were polymyositis/dermatomyotisis(9),rheumatoid arthritis(3),systemic lupus erythematosus (2),ankylosing spondylitis(1),psoriatic arthritis(1) and primary polyangiitis(1).After treatment with nonsteroidal anti-inflammatory drugs(NSAID) and glucocorticoid,elevated erythrocyte sedimentation rate(ESR) did not return to normal in most patients.Conclusion Autoimmune diseases are likely to be complicated by malignancy,especially polymyositis/dermatomyotisis.Malignancy should be excluded,if elevated ESR does not return to normal after NSAID and glucocorticoid treatment in patients with autoimmune diseases.