The objective of this study was to identify factors predictive of malignancy in patients with polymyositis (PM) and dermatomyositis (DM) in Japan. We conducted a retrospective study of PM and DM patients who were admitted to our hospital between January 1992 and September 2017. Among 134 patients, 29 (21.6%) were diagnosed with cancer in the 3 years prior to and 3 years after the initial diagnosis of PM or DM. According to multivariate analyses, male sex [odds ratio (OR) = 3.65, p = 0.03], old age (OR = 1.05, p = 0.02), and a past history of diabetes mellitus (OR = 10.4, p = 0.005) were associated with an increased risk of malignancy. The absence of interstitial lung disease (ILD) (OR = 0.25, p = 0.03) was also associated with an increased risk of malignancy. Diabetes mellitus was observed in 28.6% of PM and DM patients with malignancy, but in only 7.3% of those with malignancy. Survival was significantly lower in patients with malignancy than in those without malignancy (p < 0.001). Independent factors associated with malignancies in patients with PM or DM were male sex, old age, the absence of ILD, and, especially, a past history of diabetes mellitus.
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This work was supported in part by Grants-in-Aid for Research from the National Center for Global Health and Medicine (29-2001). The authors would like to thank Dr. Tsuneyo Mimori at the Kyoto University for the measurement of myositis-specific autoantibodies.
KM designed the study, wrote the initial draft of the manuscript and analyzed date. HY contributed to analysis and interpretation of data, and assisted in the preparation of the manuscript. SY, YT and HK, members of the Division of Rheumatic Diseases, National Center for Global Health and Medicine have contributed to data collection and interpretation, and critically reviewed the manuscript. All authors approved the final version of the manuscript, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Compliance with ethical standards
Conflict of interest
None of the authors, including Kyoko Motomura, Hiroyuki Yamashita, Saeko Yamada, Yuko Takahashi and Hiroshi Kaneko have any conflicts of interest associated with this article.
This study complied with the principles of the Declaration of Helsinki and was approved by the Ethics Committee at the National Center for Global Health and Medicine (2018-5-11/NCGM-G-002515-00).
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