Clinical and laboratory parameters predicting cancer in dermatomyositis patients with anti-TIF1γ antibodies

Background: Dermatomyositis (DM) is a chronic acquired autoimmune disorder strongly associated with cancer development. Until now, identifying predictive markers indicating a high risk of cancer has challenged clinicians. Although anti-TIF1 gamma antibody is a major serological indicator for cancer-associated DM, many anti-TIF1 gamma antibody-positive DM patients lack malignancy. Objectives: To determine clinical and laboratory parameters that support cancer prediction in anti-TIF1 gamma antibody-positive DM patients. Methods: Clinical and laboratory data were collected from cancer-associated and unassociated DM patients with anti-TIF1 gamma antibodies. Serum cytokine concentrations were measured with a cytokine array assay. The values of inflammatory cytokines in cancer prognosis were determined with a receiver operating characteristic curve analysis. Results: The cancer group had a significantly higher frequency of males, older mean age and higher anti-TIF1 gamma antibody levels. Some inflammatory cytokines, particularly tumour necrosis factor (TNF) and TNF receptor superfamilies, had increased levels in sera that were correlated with myositis markers, cutaneous severity and DM disease activity. Moreover, these cytokines had an area under the curve (AUC) >= 0.8 and high sensitivity and specificity at their specific cut-off, even higher than anti-TIF1 gamma levels in cancer prediction in our DM patients. Conclusions: Our results suggest a close pathophysiological relationship among myositis, cancer and skin involvements in DM patients with anti-TIF1 gamma antibodies and the potential clinical significance of anti-TIF1 gamma antibody levels in evaluating disease severity and prognosis in DM patients. Some inflammatory cytokines, particularly TNF and TNF receptor superfamilies including BAFF, sTNF-R1 and sTNF-R2, may support cancer prediction in DM patients with anti-TIF1 gamma antibodies. (C) 2021 Published by Elsevier B.V. on behalf of Japanese Society for Investigative Dermatology.

Automated summary

This study aimed to identify clinical and laboratory parameters supporting cancer prediction in anti-TIF1 gamma antibody-positive DM patients. The cancer group showed a higher proportion of males, older age, and higher levels of anti-TIF1 gamma antibodies. Inflammatory cytokines, particularly TNF and TNF receptor superfamilies, were found to be elevated in cancer-associated DM patients and may serve as potential markers for cancer prediction.