Use of Anti-transcriptional Intermediary Factor-1 Gamma Autoantibody in Identifying Adult Dermatomyositis Patients with Cancer: A Systematic Review and Meta-analysis
Marion Best, Nicolas Molinari, François Chasset, Thierry Vincent, Nadège Cordel, Didier Bessis
Anti-transcriptional intermediary factor-1γ (TIF-1γ) autoantibody may be associated with cancer in adult patients with dermatomyositis. The aim of this study was to evaluate the risk of cancer in the presence of anti-TIF-1γ autoantibody in adult dermatomyositis. A comprehensive database search of EMBASE, MEDLINE and the Cochrane Library up to May 2018 was performed using the main key words “dermatomyositis”, “”myositis”, “inflammatory myopathies” and “anti-TIF-1”. Eighteen studies, with a total of 1,962 dermatomyositis, were included in the meta-analysis. The pooled prevalence of cancer-associated dermatomyositis in patients with anti-TIF-1γ autoantibody was 0.41 (95% confidence interval (CI) 0.36–0.45). In the presence of anti-TIF-1γ autoantibody, the overall diagnostic odds ratio of cancer was 9.37 (95% CI 5.37–16.34) with low heterogeneity (Cochran’s Q: 14.88 (df = 17, p = 0.604); I2 = 0%). The results of this systematic review confirm that detection of anti-TIF-1γ autoantibody is a valuable tool to identify a subset of adult dermatomyositis patients with higher risk of cancer.
The risk of cancer in adults with dermatomyositis has been reported extensively in the literature, with a global malignancy rate ranging from 6.7% to 32%. Identifying adult patients with dermatomyositis at high risk for cancer is a challenge for clinicians. In this systematic review and meta-analysis of all relevant published studies the myositis-specific autoantibody anti-Tif1gamma has been confirmed to be a valuable tool to identify a subset of adult DM patients with higher risk (9.37 fold) of cancer.