Malignancy Risk and Myositis-Specific Autoantibodies in Dermatomyositis: A Comprehensive Review
DOI:
https://doi.org/10.12775/QS.2026.60.72808Keywords
dermatomyositis, cancer risk, dermatomyositis autoantibodies, anti-TIF1, anti-NXP2, anti-SAE, anti-Mi-2, anti-MDA5, malignancy, MSAsAbstract
Background. Dermatomyositis is an inflammatory myopathy characterized by proximal muscle weakness, cutaneous manifestations and systemic complications. DM has an association with cancer. Meta-analyses indicating an OR of 4.66 for developing malignancies. Especially within the first year of DM diagnosis. Myositis-specific autoantibodies (MSAs) have a distinct correlation with clinical phenotypes and the risk of developing a malignancy.
Aim. The aim of this review is to synthesize current data on the risk of malignancy in DM patients positive for MSAs and to determinate how the presence of those antibodies affects the course of cancer.
Material and methods. Comprehensive literature research was conducted across PubMed, Scopus, Web of Science, and Google Scholar databases focusing primary on publications from the past 20 years (2006-2026). Eligibility was restricted to systematic reviews, retrospective studies, cohort studies, and case reports, while conference abstracts and studies specifically concerning juvenile dermatomyositis were excluded.
Results. Anti-TIF1γ antibody presents the strongest correlation with malignancy. The predominant cancer types are breast, lung, ovarian and gastrointestinal cancer. Solid tumours presented at an advanced stage. The risk is increased by the presence of anti-TIF1α antibody, age over 60 and male sex. Patients with anti-NXP2 antibodies have a 2.5 to 3.68-fold increased risk of cancer. Tumours present at an advanced stage. Male sex and age over 60 are risk factors. Anti-Mi-2 and anti-SAE antibodies are highly population-dependent.The anti-MDA5 antibody presents a weak association with malignancy.
Conclusions. MSAs provide prognostic value for stratifying malignancy risk and optimizing screening timelines in adult dermatomyositis. Seropositivity for anti-TIF1γ and anti-NXP2 requires a prompt cancer screening within the first year of DM onset. Systematic malignancy surveillance should be standardized for all DM patients
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