Tumor Antigen Markers for the Detection of Solid Cancers in Inflammatory Myopathies

Dermatomyositis and polymyositis patients have an increased risk of developing cancers. We have assessed the diagnostic values of serum tumor markers for the detection of solid cancer in dermatomyositis/polymyositis patients. Serum carcinoembryonic antigen, CA15-3, CA19-9, and CA125 were assayed by...

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Published in:Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2005-05, Vol.14 (5), p.1279-1282
Main Authors: AMOURA, Zahir, DUHAUT, Pierre, GRENIER, Philippe, VALEYRE, Dominique, PIETTE, Jean-Charles, DU LE THI HUONG, WECHSLER, Bertrand, COSTEDOAT-CHALUMEAU, Nathalie, FRANCES, Camille, CACOUB, Patrice, PAPO, Thomas, CORMONT, Sylvie, TOUITOU, Yvan
Format: Article
Language:English
Subjects:
Adult
Aged
Antigens, Tumor-Associated, Carbohydrate - blood
Biological and medical sciences
Biomarkers, Tumor - blood
Carcinoembryonic Antigen - blood
Cohort Studies
Dermatomyositis - diagnosis
Diseases of the osteoarticular system
Female
France - epidemiology
Humans
Immunoradiometric Assay
Male
Medical sciences
Middle Aged
Miscellaneous. Osteoarticular involvement in other diseases
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Neoplasms, Unknown Primary - diagnosis
Neoplasms, Unknown Primary - epidemiology
Paraneoplastic Syndromes - diagnosis
Paraneoplastic Syndromes - epidemiology
Polymyositis - complications
Polymyositis - diagnosis
Polymyositis - epidemiology
Risk Factors
Tumors
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Summary:Dermatomyositis and polymyositis patients have an increased risk of developing cancers. We have assessed the diagnostic values of serum tumor markers for the detection of solid cancer in dermatomyositis/polymyositis patients. Serum carcinoembryonic antigen, CA15-3, CA19-9, and CA125 were assayed by immunoradiometric methods in 102 dermatomyositis/polymyositis patients. All the patients had complete physical examination, chest X-ray, echocardiogram, gastrointestinal tract endoscopic explorations, thoracoabdomino-pelvic computed tomography scan, and all women had gynecologic examination and mammogram. Exclusion criteria for study were childhood dermatomyositis, inclusion body myositis, myositis associated with a connective tissue disease, prior history of cancer, and the presence of benign conditions known to elevate serum tumor markers. After a median follow-up of 59 months, 10 (9.8%) patients had a solid cancer. Initial elevation of CA125 was associated with an increased risk of developing solid cancer [ P = 0.0001 by Fisher's exact test; odds ratio (OR), 29.7; 95% confidence interval (95% CI), 8.2-106.6]. For CA19-9, there was a trend towards a significant association ( P = 00.7; OR, 4.5; 95% CI, 1-18.7, respectively). Diagnostic values of elevated CA125 and CA19-9 at screening increased when the study analysis was restricted to patients who developed a cancer within 1 year ( P < 0.0001 and P = 0.018, respectively) or to patients without interstitial lung disease ( P = 0.00001; OR, 133; 95% CI, 6.5-2733 and P = 0.027; OR, 9; 95% CI, 1.5-53, respectively). Individual comparisons of the baseline and the second CA125 value showed that three of the eight patients with cancers versus 3 of the 76 patients without, displayed an increase of their CA125 level ( P = 0.01 by Fisher's exact test). We conclude that CA125 and CA19-9 assessment could be useful markers of the risk of developing tumors for patients with dermatomyositis and polymyositis and should therefore be included in the search for cancer in dermatomyositis/polymyositis patients, especially for patients without interstitial lung disease.
ISSN:1055-9965
1538-7755
DOI:10.1158/1055-9965.EPI-04-0624