Cancer associated autoantibodies in idiopathic inflammatory myopathies: A retrospective cohort from a single center in China

array:22 ["pii" => "S2387020622005824" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.03.023" "estado" => "S300" "fechaPublicacion" => "2023-01-05" "aid" => "5986" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;160:10-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S2387020622005812" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.03.022" "estado" => "S300" "fechaPublicacion" => "2023-01-05" "aid" => "5980" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;160:17-22" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Clinical characteristics, management, and outcome of eosinophilic pneumonia associated with daptomycin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "17" "paginaFinal" => "22" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Características clínicas, tratamiento y evolución de la neumonía eosinofílica asociada a daptomicina" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1685 "Ancho" => 2508 "Tamanyo" => 222493 ] ] "descripcion" => array:1 [ "en" => "Flowchart of study selection and inclusion." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Cuifang Wu, Zuojun Li, Chunjiang Wang, Zhenzhen Deng" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Cuifang" "apellidos" => "Wu" ] 1 => array:2 [ "nombre" => "Zuojun" "apellidos" => "Li" ] 2 => array:2 [ "nombre" => "Chunjiang" "apellidos" => "Wang" ] 3 => array:2 [ "nombre" => "Zhenzhen" "apellidos" => "Deng" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005812?idApp=UINPBA00004N" "url" => "/23870206/0000016000000001/v1_202301060844/S2387020622005812/v1_202301060844/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020622005721" "issn" => "23870206" "doi" => "10.1016/j.medcle.2022.03.021" "estado" => "S300" "fechaPublicacion" => "2023-01-05" "aid" => "5978" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Med Clin. 2023;160:1-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Survival impact of previous statin therapy in patients hospitalized with COVID-19" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "9" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Impacto del tratamiento previo con estatinas sobre la supervivencia de los pacientes hospitalizados con COVID-19" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 3022 "Ancho" => 2463 "Tamanyo" => 261904 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0050" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Hazard ratio for all-cause mortality in hospitalized patients with COVID-19 receiving statin therapy prior to admission vs. patients without statin treatment: inverse probability of treatment weighted-Cox regression analysis." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Eduardo Barge-Caballero, Pedro J. Marcos-Rodríguez, Nieves Domenech-García, Germán Bou-Arévalo, Javier Cid-Fernández, Raquel Iglesias-Reinoso, Paula López-Vázquez, Javier Muñiz, José M. Vázquez-Rodríguez, María G. Crespo-Leiro" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Barge-Caballero" ] 1 => array:2 [ "nombre" => "Pedro J." "apellidos" => "Marcos-Rodríguez" ] 2 => array:2 [ "nombre" => "Nieves" "apellidos" => "Domenech-García" ] 3 => array:2 [ "nombre" => "Germán" "apellidos" => "Bou-Arévalo" ] 4 => array:2 [ "nombre" => "Javier" "apellidos" => "Cid-Fernández" ] 5 => array:2 [ "nombre" => "Raquel" "apellidos" => "Iglesias-Reinoso" ] 6 => array:2 [ "nombre" => "Paula" "apellidos" => "López-Vázquez" ] 7 => array:2 [ "nombre" => "Javier" "apellidos" => "Muñiz" ] 8 => array:2 [ "nombre" => "José M." "apellidos" => "Vázquez-Rodríguez" ] 9 => array:2 [ "nombre" => "María G." "apellidos" => "Crespo-Leiro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775322001890" "doi" => "10.1016/j.medcli.2022.03.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775322001890?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005721?idApp=UINPBA00004N" "url" => "/23870206/0000016000000001/v1_202301060844/S2387020622005721/v1_202301060844/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Cancer associated autoantibodies in idiopathic inflammatory myopathies: A retrospective cohort from a single center in China" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "10" "paginaFinal" => "16" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Yin Zhao, Haiyuan Su, Xiaoyang Yin, Hou Hou, Ying’ai Wang, Yong Xu, Xin Li, Nang Zhang, Wenwen Sun, Wei Wei" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Yin" "apellidos" => "Zhao" ] 1 => array:2 [ "nombre" => "Haiyuan" "apellidos" => "Su" ] 2 => array:2 [ "nombre" => "Xiaoyang" "apellidos" => "Yin" ] 3 => array:2 [ "nombre" => "Hou" "apellidos" => "Hou" ] 4 => array:2 [ "nombre" => "Ying’ai" "apellidos" => "Wang" ] 5 => array:2 [ "nombre" => "Yong" "apellidos" => "Xu" ] 6 => array:2 [ "nombre" => "Xin" "apellidos" => "Li" ] 7 => array:2 [ "nombre" => "Nang" "apellidos" => "Zhang" ] 8 => array:2 [ "nombre" => "Wenwen" "apellidos" => "Sun" ] 9 => array:4 [ "nombre" => "Wei" "apellidos" => "Wei" "email" => array:1 [ 0 => "tjweiwei2003@163.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin 300020, China" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Autoanticuerpos relacionados con el cáncer en miopatía inflamatoria idiopática: estudio retrospectivo de cohortes de un solo centro en China" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 992 "Ancho" => 1258 "Tamanyo" => 69993 ] ] "descripcion" => array:1 [ "en" => "Temporal relationship between the onset of IIMs and cancer diagnosis within anti-TIF1-γ-positive patients." ] ] ] "textoCompleto" => "IntroductionIdiopathic inflammatory myopathies (IIMs) are a heterogeneous group of systemic autoimmune diseases, which mainly affect skeletal muscle.<a class="elsevierStyleCrossRef" href="#bib0220">1</a> Additionally, skin lesions, arthritis/arthralgia, interstitial lung disease (ILD), as well as gastrointestinal and cardiac involvement are also observed in patients with IIMs.<a class="elsevierStyleCrossRef" href="#bib0225">2</a> Main clinical subtypes include polymyositis (PM), dermatomyositis (DM), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis (sIBM) and the anti-synthetase syndrome (ASS).<a class="elsevierStyleCrossRefs" href="#bib0230">3,4</a> A systematic review estimated the epidemiology of IIMs and found that the incidence of IIMs ranged from 1.16 to 19/1000000/year and their prevalence ranged from 2.4 to 33.8 per 100000 inhabitants.<a class="elsevierStyleCrossRef" href="#bib0240">5</a> Though the rarity of IIMs has been determined, as the poor overall prognosis of IIMs has been proved, there is still a need to characterize patients’ features and improve their prognoses.The increased risk of cancer in patients with IIMs, especially in adult dermatomyositis, has long been recognized.<a class="elsevierStyleCrossRefs" href="#bib0245">6,7</a> Prevalence of cancer in IIMs varies between 6.7 and 32%.<a class="elsevierStyleCrossRef" href="#bib0255">8</a> Myositis with cancer is often referred to as cancer-associated myositis (CAM), which is typically defined as the development of a malignancy within 3 years of the diagnosis of myositis (before or after).<a class="elsevierStyleCrossRef" href="#bib0260">9</a> In general, the survival rate of the patients with malignancy is significantly lower than that of patients without.<a class="elsevierStyleCrossRef" href="#bib0265">10</a> Additionally, in comparison to those with cancer unrelated to myositis, worse prognosis has also been determined in CAM, with an age- and sex-adjusted Cox hazard ratio (HR) of 10.8 (95% CI 1.38–84.5, p=0.02) for all-cause mortality.<a class="elsevierStyleCrossRef" href="#bib0270">11</a> Clinical phenotypes of CAM differs from primary myositis. Prognosis and life expectancy in CAM patients is mainly determined by the underlying malignant disease. Therefore, determining specific phenotypic characteristics that associated with an increased risk of cancer in IIMs can help identify patients who can benefit from targeted cancer screening.In recent years, some improvements have been made in searching biomarkers and in understanding the mechanisms of CAM. Thereinto, myositis-specific autoantibodies (MSAs) should be mentioned. Though significant clinical heterogeneity of patients with IIMs is observed, MSAs are detected uniquely in IIMs and can help to classify patients into more homogeneous groups. For instance, the most common MSAs reported to be associated with increased malignancy risk are anti-TIF1-γ, anti-nuclear matrix protein-2 (NXP-2), anti-small ubiquitin-like modifier 1 activating enzyme (SAE), as well as anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies.<a class="elsevierStyleCrossRefs" href="#bib0225">2,8,9</a> Though there are some studies that determine the clinical characteristics and prognoses of anti-TIF1-γ antibody positive IIM patients, studies exploring prognostic features of anti-TIF1-γ antibody carrying IIM patients with/without cancer are still needed. Herein, we retrospectively examined the correlations between different MSAs and cancer risk in Chinese IIM patients. We also determined the clinical characteristics and prognoses of anti-TIF1-γ antibody positive IIM patients, especially patients with malignancy.Patients and methodsPatientsThis retrospective study enrolled 312 patients with adult IIMs who were treated at the Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, China, from January 2015 to December 2020. The enrolled patients fulfilled the criteria of Bohan and Peter myositis criteria for PM/DM,<a class="elsevierStyleCrossRefs" href="#bib0275">12,13</a> the Sontheimer's criteria for clinically amyopathic DM (CADM),<a class="elsevierStyleCrossRef" href="#bib0285">14</a> the European Neuromuscular Center (ENMC) 2003 criteria for IMNM,<a class="elsevierStyleCrossRef" href="#bib0290">15</a> and the Connors's criteria for ASS,<a class="elsevierStyleCrossRef" href="#bib0295">16</a> respectively. CAM was defined as the development of a malignancy within 3 years of the diagnosis of myositis (before or after).<a class="elsevierStyleCrossRef" href="#bib0260">9</a> The study was approved by the ethics committee of the Tianjin Medical University General Hospital (approval number: IRB2021-YX-002-01).Data collecting and recordingPatients’ medical records were reviewed to obtain information about demographic and clinical data as well as cancer related data. Demographic data included age, gender, disease duration. Clinical data included fever (>37.5°C), fatigue, loss of body weight (>5%), cutaneous involvement, proximal weakness, serum level of creatine kinase (CK), myalgia, arthritis/arthralgia, dysphagia, dysarthria, interstitial lung disease (ILD) and cancer. Cutaneous manifestations of interest were mechanic's hands, Gottron's sign/papules, heliotrope rash, V sign, shawl sign, periungual erythema, cutaneous ulcer. ILD was diagnosed based on chest high resolution computer tomography.All the patients received tumor screening, including computer tomography scan of chest, abdomen and pelvis, ultrasonic examination of thyroid, superficial lymph nodes and breast. Positron emission tomography/computed tomography (PET/CT) imaging was conducted in some patients. For CAM patients, the time of cancer diagnosis, type of cancer, the time of death were obtained through medical records or telephone interview. For non-CAM patients, the date of death, which was determined by medical records or by telephone if the death occurred outside of the hospital, was recorded. The duration of follow-up was defined as the time from the first diagnosis until the date of death or December 2021 for survivor.Assays for myositis-specific antibodiesSerum MSAs including anti-Mi-2, anti-TIF1-γ, anti-NXP2, anti-SAE, anti-MDA5, anti-SRP, anti-Jo-1, anti-PL-7, anti-PL-12, anti-OJ and anti-EJ antibodies were detected using line blot assay (LB) (EUROIMMUN, Germany) according to the manufacturer's protocol. Those with 2+ or more were considered positive in LB. The anti-HMGCR autoantibody was detected using the ELISA assay (Inova Diagnostics, USA) according to the manufacturer's protocol.Statistical analysisFor the description of quantitative data, the normal distribution groups were described as the mean±standard deviation, and the skewed distribution groups were described by the median [25th percentile, 75th percentile], whereas categorical variables were presented as number positive/percentage. Group comparisons were made using Student's t test (quantitative data with normal distribution), Mann–Whitney U test (quantitative data with skewed distribution), χ2 statistics (categorical data). Cancer-associated MSAs was estimated through binary logistic regression analysis. Survival was estimated using Kaplan–Meier curves; results were compared using the log-rank test. A p value of less than 0.05 was considered statistically significant. In certain condition, the corrected p value was used. All statistical analyses were performed using SPSS 20.0 statistical software (IBM). All the graphs were performed using GraphPad Prism software 8.0 for Windows (GraphPad Software).ResultsOverall patient characteristicsThe study enrolled 312 IIM patients, consisting of 128 DM/CADM, 59 PM, 111 ASS and 14 IMNM. The cohort was mostly (75.32%) female with a mean age of 52.90±13.94 years (range 18–89 years) at age of diagnosis. The mean disease duration between onset and diagnosis was 16.16±36.51 months. Their demographic, clinical features were recorded in detail in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Of these 312 adult IIM patients, serum MSAs were detected. MSAs were found in 247 (79.17%) patients in the whole cohort, including 52 with anti-Jo-1 antibody, 45 with anti-MDA5 antibody, 39 with anti-TIF1-γ antibody, 29 with anti-EJ antibody, 22 with anti-Mi-2 antibody, 15 with anti-PL-7 antibody, 12 with anti-SRP antibody, 11 with anti-PL-12 antibody, 9 with anti-NXP2 antibody, 8 patients with anti-SAE antibody, 4 with anti-OJ antibody, 1 with anti-HMGCR antibody positive, and the remaining 65 patients were MSAs-negative.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Anti-TIF1-γ antibody and anti-SAE antibody were cancer-associated autoantibodiesOf 312 enrolled patients, cancer was detected in 43 patients, of whom 34 were CAMs. In 4 out of 34 CAMs, cancers were detected more than 3 years before IIMs diagnosis, but 2 of them suffered tumor recur at the time of diagnosis of IIMs, and the remaining 2 patients suffered newly growing cancers. These 34 CAMs consisted of 25 DM/CADM, 5 ASS, 4 PM. In order to define the exact association between specific types of MSA and cancer, serum MSAs were detected. 34 CAMs included 15 of the 39 patients with anti-TIF1-γ antibody (38.46%), 5 of the 8 patients with anti-SAE antibody (62.50%), 3 of the 53 with anti-Jo-1 antibody (5.67%), 2 of 45 with anti-MDA5 antibody (4.44%), 1 of 10 patients with anti-NXP2 antibody (10.00%), 1 of 28 with anti-Mi-2 antibody (3.57%), 1 of 14 with anti-PL-12 antibody (7.14%), 1 of 29 with anti-EJ antibody (3.45%), as well as the remaining 5 patients with MSAs-negative. Logistic regression analysis was further conducted to determine which specific MSA was cancer-associated autoantibody. The results revealed that anti-TIF1-γ antibody and anti-SAE antibody were cancer-associated autoantibodies with odds ratios (95% CI) of 8.70 (3.35–22.64) and 22.31 (4.32–115.05), respectively (shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Baseline clinical features of IIM patients with anti-TIF1-γ antibodyGiven anti-TIF1-γ antibody was one the most common MSAs in our cohort and sample size of patients with anti-SAE antibody positive was too small, we further compared the clinical characteristics between IIM patients with anti-TIF1-γ antibody and those without (shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The results showed that patients with anti-TIF1-γ antibody had shorter duration between disease onset and diagnosis (9.47±11.96 vs. 17.08±38.64, p=0.010). Patients with anti-TIF1-γ antibody had a higher frequencies of skin lesions, including heliotrope rash (21/53.84% vs. 53/19.41%, p=0.000), V sign (27/69.23% vs. 69/25.27%, p=0.000), shawl sign (24/61.53% vs. 56/20.51%, p=0.000) and periungual erythema (6/15.38% vs. 12/4.39%, p=0.010). Compared with the anti-TIF1-γ antibody negative group, the patients with positive anti-TIF1-γ antibody had higher frequencies of proximal weakness (35/89.74% vs. 144/52.74%, p=0.000), dysphagia (17/43.58% vs. 60/21.97%, p=0.000) and dysarthria (6/15.38% vs. 17/6.22%, p=0.040). On the contrary, patients with anti-TIF1-γ antibody had a lower frequencies of fever (6/15.38% vs. 123/45.05%, p=0.000), arthritis/arthralgia (5/12.82% vs. 120/43.95%, p=0.000) and ILD (20/51.28% vs. 206/75.46%, p=0.002).Characteristics of anti-TIF1-γ antibody-associated cancerCancers were detected in 15 of the 39 patients with anti-TIF1-γ antibody, of the remaining 24 patients, 19 were still alive and did not develop any cancer during the median follow-up period of 52.25 months. In 2 out of 15 anti-TIF1-γ antibody-associated cancer patients, cancers were detected in 4 and 5 years before IIMs diagnosis. However, their tumor recurred at the time of diagnosis of IIMs. Therefore, we still enrolled these 2 patients. These 15 patients were predominantly female (12/80.00%). As for temporal relationship between the onset of myositis and cancer diagnosis/recurrence of the 15 anti-TIF1-γ antibody-associated CAMs, cancers or cancer recurrences were detected in 80% (12/15) patients within 1 year around myositis diagnosis (shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The most frequent cancer types in these 15 patients were ovary (6) and breast (2). Additionally, cancer in lung, liver, thyroid, stomach, colon, thymus and uterus were also detected. The sites of cancers and gender distribution were summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. The most frequent histopathologic types were high-grade serous carcinoma and adenocarcinoma. Regarding cancer stages, 8 (53.33%) patients were in an early stage (I or II) and 7 (46.67%) in an advanced stage (III or IV).<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Anti-TIF1-γ antibody was predictor of poor prognosisAll patients were followed up for a median of 30 months (range 0.5–274 months), during which 51 patients died. As for patients with anti-TIF1-γ antibody positive, 14 patients died with a median survival time of 9 months (range 2–31 months). The most common cause of death was tumor. We further explored that whether the presence of anti-TIF1-γ antibody and cancer could influence the prognosis of patients. The results showed that patients with anti-TIF1-γ antibody positive had significantly lower survival rates than the anti-TIF1-γ antibody negative group (1-year survival, 78.2% vs. 90.7%; 3-year survival, 60.3% vs. 86.4%; p=0.002) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). Besides, patients with CAM had significantly lower survival rates than the those without (1-year survival, 78.0% vs. 90.5%; 3-year survival, 57.3% vs. 85.9%; p=0.001) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). Further, for anti-TIF1-γ antibody positive patients, compared with patients without cancer, patients with anti-TIF1-γ antibody associated CAM had worse prognosis (1-year survival, 65.6% vs. 85.3%; 3-year survival, 40.0% vs. 80.4%; p=0.024) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>DiscussionIn current study, we described that anti-TIF1-γ antibody and anti-SAE antibody were two risk factor of CAM. The association between anti-TIF1-γ antibody and cancer in IIMs has long been confirmed by a number of studies.<a class="elsevierStyleCrossRefs" href="#bib0270">11,17</a> Recently, a meta-analysis of 18 cohort studies estimated that the pooled prevalence of CAM in patients with anti-TIF1-γ antibody was 40.7% [95% confidence interval (CI) 0.36–0.45].<a class="elsevierStyleCrossRef" href="#bib0300">17</a> This was consistent with the prevalence of CAM in patients with anti-TIF1-γ antibodies in our cohort. Given the high incidence of CAM in patients with anti-TIF1-γ antibody, clarifying the links between tumorigenesis and anti-TIF1-γ antibody was necessary.In the past decade, the link between autoimmunity and cancer has become a topic of continuous concern. TIF1-γ was discovered in 1999 and identified as the third member of the TIF1 protein (after TIF1-α and TIF1-β).<a class="elsevierStyleCrossRef" href="#bib0305">18</a> TIF1-γ is involved in multiple critical biological processes. The main interacting pathways of TIF1-γ are the Smad4-dependent canonical and Smad4-independent non-canonical TGF-β pathways.<a class="elsevierStyleCrossRefs" href="#bib0310">19–21</a> Through its involvement in the TGF-β pathway, TIF1-γ inhibits tumorigenesis mainly by inhibition of TGF-β-induced epithelial-to-mesenchymal transition via mono-ubiquitination of SMAD4. Inactivation, mutation or downregulation of TIF1-γ can all result in a reduction of this effect and thus promote tumorigenesis.<a class="elsevierStyleCrossRefs" href="#bib0225">2,8,22,23</a> Based on these researches, hypothetical model of links between autoimmunity and cancer had been proposed. Altered TIF1-γ antigens in tumors may provoke a specific antitumoral immune response which may secondarily extend to the target organs of myositis (muscle, skin) by cross-reactivity.<a class="elsevierStyleCrossRefs" href="#bib0225">2,8</a> Non-specific injury of muscle and skin cells can lead to regeneration with high levels of wild-type TIF1-γ autoantigen.<a class="elsevierStyleCrossRefs" href="#bib0225">2,8</a> Additionally, a genetic predisposition can explain why not all cancers with altered TIF1-γ expression lead to myositis.<a class="elsevierStyleCrossRefs" href="#bib0335">24,25</a> Importantly, Dani reported that anti-TIF1-γ antibodies may be detected before clinical symptoms of cancer and may disappear after successful treatment of cancer along with remission of IIMs.<a class="elsevierStyleCrossRef" href="#bib0345">26</a> Changed serum levels of anti-TIF1-γ antibodies in this longitudinal study supported the hypothesis mentioned above.In our cohort, the most frequent types of cancer occurred in anti-TIF1-γ positive patients were ovarian and breast cancer. Given anti-TIF1-γ positive CAM patients were female-dominant, this was comparable with those in the general female population in China.<a class="elsevierStyleCrossRef" href="#bib0350">27</a> The distribution of detected cancer sites in this study was similar to that in other cohorts in China<a class="elsevierStyleCrossRefs" href="#bib0270">11,28</a> and in Northern Europe,<a class="elsevierStyleCrossRef" href="#bib0360">29</a> while gastric cancer (8/23) was the most common malignancy in Japan.<a class="elsevierStyleCrossRef" href="#bib0365">30</a> Consistently, in one cohort of patients with DM, ovarian cancer was significantly more present in anti-TIF1-γ-positive patients than anti-TIF1-γ negative patients.<a class="elsevierStyleCrossRef" href="#bib0370">31</a> Additionally, all of the cancers in our cohort were solid cancers, no hematological malignancies were observed. However, in Oldroyd's cohort in the UK, other than breast and ovarian cancer, lymphoma was reported to be the third most common malignancy in anti-TIF1-γ positive cohort.<a class="elsevierStyleCrossRef" href="#bib0370">31</a> It is not clear whether the difference of the types of cancer between different regions is because of diet habit, geographic environment as well as ethnical differences. Further study of a large population will be necessary to determine whether any specific cancer type is associated with the anti-TIF1-γ antibody. CAM has poor prognosis and causes higher mortality. Poor prognosis of CAM patients, especially subset with anti-TIF1-γ antibody positive, was observed in our study. Older age, severe cutaneous and muscle symptoms were observed significantly more commonly in patients with CAM.<a class="elsevierStyleCrossRefs" href="#bib0355">28,32</a> Heliotrope rash, shawl sign and V sign had already been observed more commonly in patients with CAM.<a class="elsevierStyleCrossRefs" href="#bib0355">28,33,34</a> Compared with anti-TIF1-γ antibody negative patients, patients with positive anti-TIF1-γ antibody have a higher frequencies of these cutaneous manifestations in our cohort. Additionally, dysphagia at onset was another feature of CAM,<a class="elsevierStyleCrossRef" href="#bib0390">35</a> which was consistent with higher frequencies of dysphagia in patients with positive anti-TIF1-γ antibody. Therefore, patients with these cutaneous features should receive intensive malignancy screening.In our study, the mortality rate of CAM patients was significantly higher than non-CAM patients. This result was consistent with previous studies.<a class="elsevierStyleCrossRefs" href="#bib0265">10,28</a> Besides, patients with anti-TIF1-γ antibody associated cancer had worst prognosis. The main cause of death for CAM patients in this study was malignancy. Higher mortality rate of CAM patients with advanced tumor stages were observed. Therefore, prognosis and life expectancy in CAM patients is determined by the underlying malignant disease. Considering that anti-TIF1-antibody-positive associated malignancy occurred exclusively within 3 years either side of the dermatomyositis onset, and no incident cancer cases were detected in this group beyond this period,<a class="elsevierStyleCrossRef" href="#bib0370">31</a> yearly cancer screening (conventional or with PET/CT) is recommended in anti-TIF1-γ-positive patients for at least 3–5 years after diagnosis.Autoantibodies against the SAE (small ubiquitin-like modifier (SUMO) activating enzyme) were first reported in 2007 by Betteridge et al.<a class="elsevierStyleCrossRef" href="#bib0395">36</a> Since the first report of anti SAE antibodies in DM cases, the prevalence of anti-SAE antibody was described by several different cohorts, ranging from 1% to 8%.<a class="elsevierStyleCrossRefs" href="#bib0400">37–40</a> This was consistent with the frequency of anti-SAE antibodies (2.6%) in our cohort. It has been reported that anti-SAE positive is associated with widespread skin involvement, muscle involvement, ILD and dysphagia.<a class="elsevierStyleCrossRefs" href="#bib0405">38,40,41</a> However, the incidence of cancer in anti-SAE positive IIMs varied per cohort. Previous studies reported the frequency of cancer in anti-SAE-positive patients as 14–57%.<a class="elsevierStyleCrossRefs" href="#bib0400">37,39,42,43</a> In our cohort, the frequency of cancer in anti-SAE positive patients was 62.5%. Logistic regression analysis revealed that anti-SAE antibody was cancer-associated autoantibodies with odds ratios (95% CI) of 22.31 (4.32–115.05). Multivariate analysis using a large cohort will be needed to clarify the association between anti-SAE antibodies and cancers. In clinical practice, risk of malignancy should be considered in anti-SAE antibody positive patients.There are several limitations in our study. First, in this retrospective study, a patient selection bias cannot be avoided due to all data being collected from inpatient medical records in a single tertiary referral center. Second, the relatively small sample of patients with cancer makes it very difficult to draw firm conclusion on determining cancer-associated autoantibodies and their clinical features. Third, we used the one kind of method to detect the MSAs, and did not perform immunoprecipitation (IP)-western blotting (WB) assays to further confirm the specificities of these antibodies. The possible false positive or negative results might have led to potential for bias.ConclusionsIn current study, our results showed that anti-TIF1-γ antibody and anti-SAE antibody were cancer-associated autoantibodies. Our study showed that anti-TIF1-γ antibody positive CAM was a subset that comprised about half of CAM entities and had the characteristic of close temporal association with cancer detection/recurrence. The presence of anti-TIF1-γ antibody was associated with CAM. Prognosis and life expectancy in CAM patients is mainly determined by the underlying malignant disease. Therefore, rigorous screening for malignancy is important in patients with anti-TIF1-γ antibody. Additionally, risk of malignancy should be considered in anti-SAE antibody positive patients. Further studies are necessary to evaluate the biological links between cancer-associated MSAs and malignancy in IIMs. Only after we deeply understand the mechanism of tumorigenesis in IIMs, can we apply these new insights to patients and improve their prognosis.Competing interestsAuthors have declared that no conflict interests exist.Author's contributionsW.W. and Y.Z. designed the overall study. Y.Z. drafted the first manuscript. Y.Z. analyzed data; H.H. detected MSAs; Y.Z., Y.H.S, X.Y.Y, and Y.A.W. collected data; Y.H.S., X.Y.Y. and Y.X. telephoned the patients to collect survival data; X.L., W.W.S., N.Z. guided clinical diagnosis and treatment; W.W., and N.Z. made the critical revision of the manuscript, and finalized the article. All authors critically contributed to the manuscript for important intellectual content.FundingNone." "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:3 [ "identificador" => "xres1829148" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1594683" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1829147" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1594684" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Patients and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Data collecting and recording" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Assays for myositis-specific antibodies" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Overall patient characteristics" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Anti-TIF1-γ antibody and anti-SAE antibody were cancer-associated autoantibodies" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Baseline clinical features of IIM patients with anti-TIF1-γ antibody" ] 3 => array:2 [ "identificador" => "sec0055" "titulo" => "Characteristics of anti-TIF1-γ antibody-associated cancer" ] 4 => array:2 [ "identificador" => "sec0060" "titulo" => "Anti-TIF1-γ antibody was predictor of poor prognosis" ] ] ] 7 => array:2 [ "identificador" => "sec0065" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0075" "titulo" => "Competing interests" ] 10 => array:2 [ "identificador" => "sec0080" "titulo" => "Author's contributions" ] 11 => array:2 [ "identificador" => "sec0085" "titulo" => "Funding" ] 12 => array:2 [ "identificador" => "xack645213" "titulo" => "Acknowledgements" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-02-12" "fechaAceptado" => "2022-03-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1594683" "palabras" => array:4 [ 0 => "Anti-TIF1-γ antibody" 1 => "Idiopathic inflammatory myopathy" 2 => "Cancer" 3 => "Prognosis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1594684" "palabras" => array:4 [ 0 => "Anticuerpo anti-TIF1-γ" 1 => "Miopatía inflamatoria idiopática" 2 => "Cáncer" 3 => "Pronóstico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectivesIdiopathic inflammatory myopathies (IIMs) are systemic, heterogeneous diseases, which mainly affect skeletal muscle. Myositis with cancer is often referred to as cancer-associated myositis (CAM), which is associated with poor prognosis. This study aimed to determine the cancer associated myositis-specific autoantibodies (MSAs) and to elucidate their associations with clinical features in Chinese patients with IIMs. MethodsThis retrospective study enrolled 312 patients with IIMs who were treated at Tianjin Medical University General Hospital, China, from January 2015 to December 2020. Clinical data were collected. Serum MSAs, including anti-Mi-2, anti-TIF1-γ, anti-NXP2, anti-SAE, anti-MDA5, anti-SRP, anti-Jo-1, anti-PL-7, anti-PL-12, anti-OJ, anti-EJ and anti-HMGCR antibodies were detected. Cancer-associated MSAs, their phenotypic and survival features were estimated through SPSS 20.0. ResultsThe results revealed that anti-TIF1-γ antibody and anti-SAE antibody were cancer-associated autoantibodies with odds ratios (95% CI) of 8.70 (3.35–22.64) and 22.31 (4.32–115.05), respectively. Skin lesions, proximal weakness, dysphagia and dysarthria were observed more frequently in patients carrying anti-TIF1-γ antibody. By contrast, patients with anti-TIF1-γ antibody had a lower frequencies of fever, arthritis/arthralgia and interstitial lung disease (ILD). Anti-TIF1-γ antibody positive CAM comprised about half of CAM entities and had the characteristic of close temporal association with cancer detection/recurrence. Female-dominant, common reproductive system tumors were other clinical features of this subset. Besides, patients with anti-TIF1-γ antibody positive had significantly lower survival rates than the anti-TIF1-γ antibody negative group. ConclusionsAnti-TIF1-γ antibody and anti-SAE antibody were cancer-associated autoantibodies. Anti-TIF1-γ antibody positive CAM was a subset that comprised about half of CAM entities and had the characteristic of poor prognosis." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoLa miopatía inflamatoria idiopática (IIM, por sus siglas en inglés) es una enfermedad sistémica y heterogénea que afecta principalmente al músculo esquelético. La miositis asociada al cáncer se denomina a menudo miositis relacionada con el cáncer, y está relacionada con un mal pronóstico. El objetivo de este estudio fue identificar autoanticuerpos específicos de miositis relacionados con el cáncer en pacientes chinos, y dilucidar su correlación con las características clínicas. MétodosEl estudio retrospectivo incluyó a 312 pacientes con IIM tratados en el hospital general de la Universidad Médica de Tianjin, China, de enero de 2015 a diciembre de 2020. Recoger datos clínicos. Se detectaron autoanticuerpos específicos de miositis sérica, incluyendo anti-Mi-2, anti-TIF1-γ, anti-NXP2, anti-SAE, anti-MDA5, anti-SRP, anti-Jo-1, anti-PL-7, anti-PL-12, anti-OJ, anti-EJ, anti-HMGCR. Los autoanticuerpos relacionados con el cáncer, sus fenotipos y sus características de supervivencia fueron evaluados por SPSS® 20.0. ResultadosLos resultados mostraron que el anticuerpo anti-TIF1-γ y el anticuerpo anti-SAE eran autoanticuerpos relacionados con el cáncer con una relación de predominio (IC 95%) de 8,70 (3,35–22,64) y 22,31 (4,32–115,05), respectivamente. La frecuencia de lesiones cutáneas, debilidad proximal, disfagia y disartria fue mayor en los pacientes portadores de anticuerpos anti-TIF1-γ. En comparación, la incidencia de fiebre, artritis/artralgia y enfermedad pulmonar intersticial (ILD) en pacientes con anticuerpos anti-TIF1-γ fue menor. La miositis relacionada con el cáncer con anticuerpos anti-TIF1-γ positivos representa aproximadamente la mitad de la miositis relacionada con el cáncer y tiene características temporales estrechamente relacionadas con la detección/recidiva del cáncer. Los tumores del sistema reproductivo que predominan en las mujeres son otras características clínicas de este subgrupo. Además, la tasa de supervivencia de los pacientes con anticuerpos anti-TIF1-γ positivos fue significativamente menor que la del grupo anti-TIF1-γ negativo. ConclusiónLos anticuerpos anti-TIF1-γ y anti-SAE son autoanticuerpos relacionados con el tumor. Los pacientes con anticuerpos anti-TIF1-γ positivos son un subgrupo, que representa aproximadamente la mitad de los pacientes con miositis relacionada con el cáncer, y tienen un mal pronóstico." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 992 "Ancho" => 1258 "Tamanyo" => 69993 ] ] "descripcion" => array:1 [ "en" => "Temporal relationship between the onset of IIMs and cancer diagnosis within anti-TIF1-γ-positive patients." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1853 "Ancho" => 2508 "Tamanyo" => 237730 ] ] "descripcion" => array:1 [ "en" => "Cumulative survival rates for patients with IIMs. (A) Comparison between patients with anti-TIF1-γ antibody and patients without. (B) Comparison between CAMs and those non-CAMs. (C) Comparison between anti-TIF1-γ antibody positive CAMs and those anti-TIF1-γ antibody positive patients without cancer." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "p value: anti-TIF1 γ-positive subgroup vs. anti-TIF1 γ-negative subgroup." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Total subjects \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Anti-TIF1 γ-positive \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Anti-TIF1 γ-negative \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">p value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n=312 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n=39 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n=273 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Demographic</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex, female/male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">235/77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31/8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">204/69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age of onset, years, mean±SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.90±13.94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58.38±12.77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52.11±13.94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.83 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Delay between onset and diagnosis, months, mean±SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.16±36.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.47±11.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.08±38.64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General condition, no. (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fever \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">129 (41.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">123 (45.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fatigue \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">213 (68.27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (76.92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">183 (67.03) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Loss of weight (>5%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (26.92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (33.33) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71 (26.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Skin changes, no. (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Skin lesions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">202 (64.74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (92.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">166 (60.81) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mechanic's hands \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (28.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (10.26) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (16.12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gottron's sign/papules \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">106 (33.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (41.02) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 (32.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.32 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Heliotrope rash \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 (23.72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (53.84) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (19.41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">V sign \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96 (30.77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (69.23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 (25.27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Shawl sign \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 (25.64) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (61.53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 (20.51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Periungual erythema \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (5.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (4.39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Skin ulcers \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (7.05) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (12.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (6.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Extra-cutaneous manifestations</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Proximal weakness, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">179 (57.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (89.74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">144 (52.74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Myalgia, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">127 (40.71) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 (46.15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">109 (39.93) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.46 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increased CK levels, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">181 (58.01) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (51.28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">161 (58.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.34 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CK level, U/L \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2081.04±5601.77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1667.85±3250.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2140.07±5863.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.57 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Arthritis/arthralgia, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">125 (40.06) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (12.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 (43.95) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dysphagia, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 (24.68) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (43.58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 (21.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dysarthria, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (7.37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (15.38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (6.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.05 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ILD, no. (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">226 (72.44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (51.28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">206 (75.46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.01 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prognosis, no. (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Death \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51 (16.35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (35.90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37 (13.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Malignancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 (10.90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (38.46) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (6.96) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Comparison of clinical and laboratory characteristics between anti-TIF1 γ-positive and negative patients." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anti-TIF1-γ antibody \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.35–22.64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anti-SAE antibody \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22.31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.32–115.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Logistic regression analysis to determine the cancer-associated autoantibody." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n \t\t\t\t\ttable-head\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Site of cancer \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No. of cancers</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Total, n (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Female \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Male \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ovary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (40) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Breast \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lung \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Liver \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thyroid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stomach \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Colon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thymus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Uterus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Site of cancer in anti-TIF1-γ antibody-positive patients (n=15)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:43 [ 0 => array:3 [ "identificador" => "bib0220" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "NIH conference. Myositis: immunologic contributions to understanding cause, pathogenesis, and therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.H. Plotz" 1 => "L.G. Rider" 2 => "I.N. Targoff" 3 => "N. Raben" 4 => "T.P. O’Hanlon" 5 => "F.W. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/0003-4819-122-9-199505010-00010" "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1995" "volumen" => "122" "paginaInicial" => "715" "paginaFinal" => "724" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7702234" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0225" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anti-TIF1-γ autoantibodies: warning lights of a tumour autoantigen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. De Vooght" 1 => "J.B. Vulsteke" 2 => "P. De Haes" 3 => "X. Bossuyt" 4 => "R. Lories" 5 => "E. De Langhe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/rheumatology/kez572" "Revista" => array:6 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2020" "volumen" => "59" "paginaInicial" => "469" "paginaFinal" => "477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31883334" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0230" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of a new classification system for idiopathic inflammatory myopathies based on clinical manifestations and myositis-specific autoantibodies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Mariampillai" 1 => "B. Granger" 2 => "D. Amelin" 3 => "M. Guiguet" 4 => "E. Hachulla" 5 => "F. Maurier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamaneurol.2018.2598" "Revista" => array:6 [ "tituloSerie" => "JAMA Neurol" "fecha" => "2018" "volumen" => "75" "paginaInicial" => "1528" "paginaFinal" => "1537" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30208379" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0235" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I.E. Lundberg" 1 => "A. Tjärnlund" 2 => "M. Bottai" 3 => "V.P. Werth" 4 => "C. Pilkington" 5 => "M. Visser" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2017-211468" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2017" "volumen" => "76" "paginaInicial" => "1955" "paginaFinal" => "1964" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29079590" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0240" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and prevalence of inflammatory myopathies: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Meyer" 1 => "N. Meyer" 2 => "M. Schaeffer" 3 => "J.E. Gottenberg" 4 => "B. Geny" 5 => "J. Sibilia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/rheumatology/keu289" "Revista" => array:6 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2015" "volumen" => "54" "paginaInicial" => "50" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25065005" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0245" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer risk in dermatomyositis: a meta-analysis of cohort studies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Olazagasti" 1 => "P.J. Baez" 2 => "D.A. Wetter" 3 => "F.C. Ernste" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40257-015-0120-1" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Dermatol" "fecha" => "2015" "volumen" => "16" "paginaInicial" => "89" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25721032" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0250" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk of malignancy in dermatomyositis and polymyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.K. Qiang" 1 => "W.B. Kim" 2 => "A. Baibergenova" 3 => "R. Alhusayen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1203475416665601" "Revista" => array:6 [ "tituloSerie" => "J Cutan Med Surg" "fecha" => "2017" "volumen" => "21" "paginaInicial" => "131" "paginaFinal" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27534779" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0255" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatomyositis and immune-mediated necrotizing myopathies: a window on autoimmunity and cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Aussy" 1 => "O. Boyer" 2 => "N. Cordel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fimmu.2017.00992" "Revista" => array:5 [ "tituloSerie" => "Front Immunol" "fecha" => "2017" "volumen" => "8" "paginaInicial" => "992" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28871260" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0260" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of cancer-associated autoantibodies as biomarkers in paraneoplastic myositis syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "X. Lu" 1 => "Q. Peng" 2 => "G. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/BOR.0000000000000641" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Rheumatol" "fecha" => "2019" "volumen" => "31" "paginaInicial" => "643" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31369431" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0265" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characteristics and prognosis of polymyositis and dermatomyositis associated with malignancy: a 25-year retrospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Motomura" 1 => "H. Yamashita" 2 => "S. Yamada" 3 => "Y. Takahashi" 4 => "H. Kaneko" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00296-019-04428-z" "Revista" => array:6 [ "tituloSerie" => "Rheumatol Int" "fecha" => "2019" "volumen" => "39" "paginaInicial" => "1733" "paginaFinal" => "1739" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31444556" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0270" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of multiple cancer-associated myositis-specific autoantibodies in idiopathic inflammatory myopathies: a large longitudinal cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Yang" 1 => "Q. Peng" 2 => "L. Yin" 3 => "S. Li" 4 => "J. Shi" 5 => "Y. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13075-017-1469-8" "Revista" => array:5 [ "tituloSerie" => "Arthritis Res Ther" "fecha" => "2017" "volumen" => "19" "paginaInicial" => "259" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29178913" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0275" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polymyositis and dermatomyositis (first of two parts)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Bohan" 1 => "J.B. Peter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM197502132920706" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1975" "volumen" => "292" "paginaInicial" => "344" "paginaFinal" => "347" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1090839" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0280" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polymyositis and dermatomyositis (second of two parts)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Bohan" 1 => "J.B. Peter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "1975" "volumen" => "292" "paginaInicial" => "403" "paginaFinal" => "407" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0285" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Would a new name hasten the acceptance of amyopathic dermatomyositis (dermatomyositis siné myositis) as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.D. Sontheimer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/mjd.2002.120621" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2002" "volumen" => "46" "paginaInicial" => "626" "paginaFinal" => "636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11907524" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0290" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "119th ENMC international workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10–12 October 2003, Naarden, The Netherlands" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.E. Hoogendijk" 1 => "A.A. Amato" 2 => "B.R. Lecky" 3 => "E.H. Choy" 4 => "I.E. Lundberg" 5 => "M.R. Rose" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nmd.2004.02.006" "Revista" => array:6 [ "tituloSerie" => "Neuromuscul Disord" "fecha" => "2004" "volumen" => "14" "paginaInicial" => "337" "paginaFinal" => "345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15099594" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0295" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interstitial lung disease associated with the idiopathic inflammatory myopathies: what progress has been made in the past 35 years?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.R. Connors" 1 => "L. Christopher-Stine" 2 => "C.V. Oddis" 3 => "S.K. Danoff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.10-0180" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2010" "volumen" => "138" "paginaInicial" => "1464" "paginaFinal" => "1474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21138882" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0300" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of anti-transcriptional intermediary factor-1 gamma autoantibody in identifying adult dermatomyositis patients with cancer: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Best" 1 => "N. Molinari" 2 => "F. Chasset" 3 => "T. Vincent" 4 => "N. Cordel" 5 => "D. Bessis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-3091" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2019" "volumen" => "99" "paginaInicial" => "256" "paginaFinal" => "262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30460368" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0305" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "TIF1gamma, a novel member of the transcriptional intermediary factor 1 family" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Venturini" 1 => "J. You" 2 => "M. Stadler" 3 => "R. Galien" 4 => "V. Lallemand" 5 => "M.H. Koken" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.onc.1202655" "Revista" => array:6 [ "tituloSerie" => "Oncogene" "fecha" => "1999" "volumen" => "18" "paginaInicial" => "1209" "paginaFinal" => "1217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10022127" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0310" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recruitment of TIF1γ to chromatin via its PHD finger-bromodomain activates its ubiquitin ligase and transcriptional repressor activities" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Agricola" 1 => "R.A. Randall" 2 => "T. Gaarenstroom" 3 => "S. Dupont" 4 => "C.S. Hill" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.molcel.2011.05.020" "Revista" => array:6 [ "tituloSerie" => "Mol Cell" "fecha" => "2011" "volumen" => "43" "paginaInicial" => "85" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21726812" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0315" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dynamic regulation of Tgf-B signaling by Tif1γ: a computational approach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Andrieux" 1 => "L. Fattet" 2 => "M. Le Borgne" 3 => "R. Rimokh" 4 => "N. Théret" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0033761" "Revista" => array:5 [ "tituloSerie" => "PLoS ONE" "fecha" => "2012" "volumen" => "7" "paginaInicial" => "e33761" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22461896" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0320" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Regulation of TGF-β signal transduction by mono- and deubiquitylation of Smads" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Dupont" 1 => "M. Inui" 2 => "S.J. Newfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.febslet.2012.03.037" "Revista" => array:6 [ "tituloSerie" => "FEBS Lett" "fecha" => "2012" "volumen" => "586" "paginaInicial" => "1913" "paginaFinal" => "1920" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22710170" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0325" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reduced expression of transcriptional intermediary factor 1 gamma promotes metastasis and indicates poor prognosis of hepatocellular carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z.Y. Ding" 1 => "G.N. Jin" 2 => "W. Wang" 3 => "W.X. Chen" 4 => "Y.H. Wu" 5 => "X. Ai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/hep.27273" "Revista" => array:6 [ "tituloSerie" => "Hepatology" "fecha" => "2014" "volumen" => "60" "paginaInicial" => "1620" "paginaFinal" => "1636" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24954480" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0330" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Repression of TIF1γ by SOX2 promotes TGF-β-induced epithelial-mesenchymal transition in non-small-cell lung cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Wang" 1 => "H. Yang" 2 => "Z. Lei" 3 => "J. Zhao" 4 => "Y. Chen" 5 => "P. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/onc.2015.141" "Revista" => array:6 [ "tituloSerie" => "Oncogene" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "867" "paginaFinal" => "877" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25961934" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0335" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Focused HLA analysis in Caucasians with myositis identifies significant associations with autoantibody subgroups" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Rothwell" 1 => "H. Chinoy" 2 => "J.A. Lamb" 3 => "F.W. Miller" 4 => "L.G. Rider" 5 => "L.R. Wedderburn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2019-215046" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2019" "volumen" => "78" "paginaInicial" => "996" "paginaFinal" => "1002" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31138531" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0340" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A novel autoantibody to a 155-kd protein is associated with dermatomyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I.N. Targoff" 1 => "G. Mamyrova" 2 => "E.P. Trieu" 3 => "O. Perurena" 4 => "B. Koneru" 5 => "T.P. O’Hanlon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/art.22164" "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "2006" "volumen" => "54" "paginaInicial" => "3682" "paginaFinal" => "3689" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17075819" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0345" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anti-transcriptional intermediary factor 1 gamma antibodies in cancer-associated myositis: a longitudinal study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Dani" 1 => "M. Holmqvist" 2 => "M.A. Martínez" 3 => "E. Trallero-Araguas" 4 => "M. Dastmalchi" 5 => "J. Svensson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Rheumatol" "fecha" => "2020" "volumen" => "38" "paginaInicial" => "67" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31365334" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0350" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer statistics in China, 2015" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Chen" 1 => "R. Zheng" 2 => "P.D. Baade" 3 => "S. Zhang" 4 => "H. Zeng" 5 => "F. Bray" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3322/caac.21338" "Revista" => array:6 [ "tituloSerie" => "CA Cancer J Clin" "fecha" => "2016" "volumen" => "66" "paginaInicial" => "115" "paginaFinal" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26808342" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0355" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors for cancer-associated myositis: a large-scale multicenter cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Li" 1 => "X. Jia" 2 => "X. Sun" 3 => "L. Shi" 4 => "F. Lin" 5 => "Y. Gan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1756-185X.14046" "Revista" => array:6 [ "tituloSerie" => "Int J Rheum Dis" "fecha" => "2021" "volumen" => "24" "paginaInicial" => "268" "paginaFinal" => "273" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33369084" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0360" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.L. Hill" 1 => "Y. Zhang" 2 => "B. Sigurgeirsson" 3 => "E. Pukkala" 4 => "L. Mellemkjaer" 5 => "A. Airio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(00)03540-6" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2001" "volumen" => "357" "paginaInicial" => "96" "paginaFinal" => "100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11197446" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0365" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and predictive factors for malignancies in 136 Japanese patients with dermatomyositis, polymyositis and clinically amyopathic dermatomyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Azuma" 1 => "H. Yamada" 2 => "M. Ohkubo" 3 => "Y. Yamasaki" 4 => "M. Yamasaki" 5 => "M. Mizushima" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Mol Rheumatol" "fecha" => "2011" "volumen" => "21" "paginaInicial" => "178" "paginaFinal" => "183" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0370" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The temporal relationship between cancer and adult onset anti-transcriptional intermediary factor 1 antibody-positive dermatomyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Oldroyd" 1 => "J.C. Sergeant" 2 => "P. New" 3 => "N.J. McHugh" 4 => "Z. Betteridge" 5 => "J.A. Lamb" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/rheumatology/key357" "Revista" => array:6 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2019" "volumen" => "58" "paginaInicial" => "650" "paginaFinal" => "655" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30535395" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0375" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer-associated myositis: clinical features and prognostic signs" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ponyi" 1 => "T. Constantin" 2 => "M. Garami" 3 => "C. András" 4 => "B. Tállai" 5 => "A. Váncsa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1196/annals.1361.047" "Revista" => array:6 [ "tituloSerie" => "Ann N Y Acad Sci" "fecha" => "2005" "volumen" => "1051" "paginaInicial" => "64" "paginaFinal" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16126945" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0380" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retrospective analysis of cancer-associated myositis patients over the past 3 decades in a hungarian myositis cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. András" 1 => "L. Bodoki" 2 => "M. Nagy-Vincze" 3 => "Z. Griger" 4 => "E. Csiki" 5 => "K. Dankó" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12253-019-00756-4" "Revista" => array:6 [ "tituloSerie" => "Pathol Oncol Res" "fecha" => "2020" "volumen" => "26" "paginaInicial" => "1749" "paginaFinal" => "1755" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31646426" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0385" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characteristics of cancer-associated myositis complicated by interstitial lung disease: a large-scale multicentre cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Kaneko" 1 => "T. Nunokawa" 2 => "Y. Taniguchi" 3 => "Y. Yamaguchi" 4 => "T. Gono" 5 => "K. Masui" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/rheumatology/kez238" "Revista" => array:6 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2020" "volumen" => "59" "paginaInicial" => "112" "paginaFinal" => "119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31382295" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0390" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer-associated myositis: a 35-year retrospective study of a monocentric cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Neri" 1 => "S. Barsotti" 2 => "V. Iacopetti" 3 => "G. Iacopetti" 4 => "P. Pepe" 5 => "A. d’Ascanio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00296-013-2910-1" "Revista" => array:6 [ "tituloSerie" => "Rheumatol Int" "fecha" => "2014" "volumen" => "34" "paginaInicial" => "565" "paginaFinal" => "569" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24322453" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0395" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of a novel autoantibody directed against small ubiquitin-like modifier activating enzyme in dermatomyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Z. Betteridge" 1 => "H. Gunawardena" 2 => "J. North" 3 => "J. Slinn" 4 => "N. McHugh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/art.22862" "Revista" => array:6 [ "tituloSerie" => "Arthritis Rheum" "fecha" => "2007" "volumen" => "56" "paginaInicial" => "3132" "paginaFinal" => "3137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17763420" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0400" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High incidence of cancer in anti-small ubiquitin-like modifier activating enzyme antibody-positive dermatomyositis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y. Muro" 1 => "K. Sugiura" 2 => "M. Nara" 3 => "I. Sakamoto" 4 => "N. Suzuki" 5 => "M. Akiyama" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/rheumatology/kev247" "Revista" => array:6 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2015" "volumen" => "54" "paginaInicial" => "1745" "paginaFinal" => "1747" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26163288" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0405" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A North American cohort of anti-SAE dermatomyositis: clinical phenotype, testing, and review of cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Albayda" 1 => "C. Mecoli" 2 => "L. Casciola-Rosen" 3 => "S.K. Danoff" 4 => "C.T. Lin" 5 => "D. Hines" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/acr2.11247" "Revista" => array:6 [ "tituloSerie" => "ACR Open Rheumatol" "fecha" => "2021" "volumen" => "3" "paginaInicial" => "287" "paginaFinal" => "294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33774928" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0410" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Four dermatomyositis-specific autoantibodies-anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5-in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Bodoki" 1 => "M. Nagy-Vincze" 2 => "Z. Griger" 3 => "Z. Betteridge" 4 => "L. Szöllősi" 5 => "K. Dankó" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.autrev.2014.08.011" "Revista" => array:6 [ "tituloSerie" => "Autoimmun Rev" "fecha" => "2014" "volumen" => "13" "paginaInicial" => "1211" "paginaFinal" => "1219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25182203" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0415" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Zampeli" 1 => "A. Venetsanopoulou" 2 => "O.D. Argyropoulou" 3 => "C.P. Mavragani" 4 => "M.G. Tektonidou" 5 => "P.G. Vlachoyiannopoulos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-018-4267-z" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2019" "volumen" => "38" "paginaInicial" => "125" "paginaFinal" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30145635" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0420" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum and clinical significance of myositis-specific autoantibodies in Chinese patients with idiopathic inflammatory myopathies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Li" 1 => "Y. Ge" 2 => "H. Yang" 3 => "T. Wang" 4 => "X. Zheng" 5 => "Q. Peng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-019-04503-7" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2019" "volumen" => "38" "paginaInicial" => "2171" "paginaFinal" => "2179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30863950" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0425" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and human leucocyte antigen class II haplotype associations of autoantibodies to small ubiquitin-like modifier enzyme, a dermatomyositis-specific autoantigen target, in UK Caucasian adult-onset myositis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Z.E. Betteridge" 1 => "H. Gunawardena" 2 => "H. Chinoy" 3 => "J. North" 4 => "W.E. Ollier" 5 => "R.G. Cooper" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2009" "volumen" => "68" "paginaInicial" => "1621" "paginaFinal" => "1625" ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0430" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Autoantibodies to small ubiquitin-like modifier activating enzymes in Japanese patients with dermatomyositis: comparison with a UK Caucasian cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Fujimoto" 1 => "T. Matsushita" 2 => "Y. Hamaguchi" 3 => "K. Kaji" 4 => "Y. Asano" 5 => "F. Ogawa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2012-201736" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2013" "volumen" => "72" "paginaInicial" => "151" "paginaFinal" => "153" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22843487" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack645213" "titulo" => "Acknowledgements" "texto" => "The authors would like to acknowledge the colleagues in the departments for their help in the preparation of this work." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016000000001/v1_202301060844/S2387020622005824/v1_202301060844/en/main.assets" "Apartado" => array:4 [ "identificador" => "43310" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016000000001/v1_202301060844/S2387020622005824/v1_202301060844/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005824?idApp=UINPBA00004N"]

Statistics

Original article

Cancer associated autoantibodies in idiopathic inflammatory myopathies: A retrospective cohort from a single center in China

Autoanticuerpos relacionados con el cáncer en miopatía inflamatoria idiopática: estudio retrospectivo de cohortes de un solo centro en China

Yin Zhao, Haiyuan Su, Xiaoyang Yin, Hou Hou, Ying’ai Wang, Yong Xu, Xin Li, Nang Zhang, Wenwen Sun, Wei Wei

Corresponding author

tjweiwei2003@163.com

Corresponding author.

Department of Rheumatology and Immunology, Tianjin Medical University General Hospital, Tianjin 300020, China

Read

Times
was read the article

Total PDF

Total HTML

Share statistics

 array:22 [
  "pii" => "S2387020622005824"
  "issn" => "23870206"
  "doi" => "10.1016/j.medcle.2022.03.023"
  "estado" => "S300"
  "fechaPublicacion" => "2023-01-05"
  "aid" => "5986"
  "copyrightAnyo" => "2022"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Med Clin. 2023;160:10-6"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2387020622005812"
    "issn" => "23870206"
    "doi" => "10.1016/j.medcle.2022.03.022"
    "estado" => "S300"
    "fechaPublicacion" => "2023-01-05"
    "aid" => "5980"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Clin. 2023;160:17-22"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Clinical characteristics&#44; management&#44; and outcome of eosinophilic pneumonia associated with daptomycin"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "17"
          "paginaFinal" => "22"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Caracter&#237;sticas cl&#237;nicas&#44; tratamiento y evoluci&#243;n de la neumon&#237;a eosinof&#237;lica asociada a daptomicina"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1685
              "Ancho" => 2508
              "Tamanyo" => 222493
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flowchart of study selection and inclusion&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Cuifang Wu, Zuojun Li, Chunjiang Wang, Zhenzhen Deng"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Cuifang"
              "apellidos" => "Wu"
            ]
            1 => array:2 [
              "nombre" => "Zuojun"
              "apellidos" => "Li"
            ]
            2 => array:2 [
              "nombre" => "Chunjiang"
              "apellidos" => "Wang"
            ]
            3 => array:2 [
              "nombre" => "Zhenzhen"
              "apellidos" => "Deng"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005812?idApp=UINPBA00004N"
    "url" => "/23870206/0000016000000001/v1_202301060844/S2387020622005812/v1_202301060844/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2387020622005721"
    "issn" => "23870206"
    "doi" => "10.1016/j.medcle.2022.03.021"
    "estado" => "S300"
    "fechaPublicacion" => "2023-01-05"
    "aid" => "5978"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Clin. 2023;160:1-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Survival impact of previous statin therapy in patients hospitalized with COVID-19"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1"
          "paginaFinal" => "9"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Impacto del tratamiento previo con estatinas sobre la supervivencia de los pacientes hospitalizados con COVID-19"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0015"
          "etiqueta" => "Fig&#46; 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 3022
              "Ancho" => 2463
              "Tamanyo" => 261904
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0050"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hazard ratio for all-cause mortality in hospitalized patients with COVID-19 receiving statin therapy prior to admission vs&#46; patients without statin treatment&#58; inverse probability of treatment weighted-Cox regression analysis&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Eduardo Barge-Caballero, Pedro J&#46; Marcos-Rodr&#237;guez, Nieves Domenech-Garc&#237;a, Germ&#225;n Bou-Ar&#233;valo, Javier Cid-Fern&#225;ndez, Raquel Iglesias-Reinoso, Paula L&#243;pez-V&#225;zquez, Javier Mu&#241;iz, Jos&#233; M&#46; V&#225;zquez-Rodr&#237;guez, Mar&#237;a G&#46; Crespo-Leiro"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Eduardo"
              "apellidos" => "Barge-Caballero"
            ]
            1 => array:2 [
              "nombre" => "Pedro J&#46;"
              "apellidos" => "Marcos-Rodr&#237;guez"
            ]
            2 => array:2 [
              "nombre" => "Nieves"
              "apellidos" => "Domenech-Garc&#237;a"
            ]
            3 => array:2 [
              "nombre" => "Germ&#225;n"
              "apellidos" => "Bou-Ar&#233;valo"
            ]
            4 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Cid-Fern&#225;ndez"
            ]
            5 => array:2 [
              "nombre" => "Raquel"
              "apellidos" => "Iglesias-Reinoso"
            ]
            6 => array:2 [
              "nombre" => "Paula"
              "apellidos" => "L&#243;pez-V&#225;zquez"
            ]
            7 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Mu&#241;iz"
            ]
            8 => array:2 [
              "nombre" => "Jos&#233; M&#46;"
              "apellidos" => "V&#225;zquez-Rodr&#237;guez"
            ]
            9 => array:2 [
              "nombre" => "Mar&#237;a G&#46;"
              "apellidos" => "Crespo-Leiro"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0025775322001890"
        "doi" => "10.1016/j.medcli.2022.03.015"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775322001890?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005721?idApp=UINPBA00004N"
    "url" => "/23870206/0000016000000001/v1_202301060844/S2387020622005721/v1_202301060844/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Cancer associated autoantibodies in idiopathic inflammatory myopathies&#58; A retrospective cohort from a single center in China"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "10"
        "paginaFinal" => "16"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Yin Zhao, Haiyuan Su, Xiaoyang Yin, Hou Hou, Ying&#8217;ai Wang, Yong Xu, Xin Li, Nang Zhang, Wenwen Sun, Wei Wei"
        "autores" => array:10 [
          0 => array:2 [
            "nombre" => "Yin"
            "apellidos" => "Zhao"
          ]
          1 => array:2 [
            "nombre" => "Haiyuan"
            "apellidos" => "Su"
          ]
          2 => array:2 [
            "nombre" => "Xiaoyang"
            "apellidos" => "Yin"
          ]
          3 => array:2 [
            "nombre" => "Hou"
            "apellidos" => "Hou"
          ]
          4 => array:2 [
            "nombre" => "Ying&#8217;ai"
            "apellidos" => "Wang"
          ]
          5 => array:2 [
            "nombre" => "Yong"
            "apellidos" => "Xu"
          ]
          6 => array:2 [
            "nombre" => "Xin"
            "apellidos" => "Li"
          ]
          7 => array:2 [
            "nombre" => "Nang"
            "apellidos" => "Zhang"
          ]
          8 => array:2 [
            "nombre" => "Wenwen"
            "apellidos" => "Sun"
          ]
          9 => array:4 [
            "nombre" => "Wei"
            "apellidos" => "Wei"
            "email" => array:1 [
              0 => "tjweiwei2003@163.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Department of Rheumatology and Immunology&#44; Tianjin Medical University General Hospital&#44; Tianjin 300020&#44; China"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Autoanticuerpos relacionados con el c&#225;ncer en miopat&#237;a inflamatoria idiop&#225;tica&#58; estudio retrospectivo de cohortes de un solo centro en China"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 992
            "Ancho" => 1258
            "Tamanyo" => 69993
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Temporal relationship between the onset of IIMs and cancer diagnosis within anti-TIF1-&#947;-positive patients&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Idiopathic inflammatory myopathies &#40;IIMs&#41; are a heterogeneous group of systemic autoimmune diseases&#44; which mainly affect skeletal muscle&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a> Additionally&#44; skin lesions&#44; arthritis&#47;arthralgia&#44; interstitial lung disease &#40;ILD&#41;&#44; as well as gastrointestinal and cardiac involvement are also observed in patients with IIMs&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a> Main clinical subtypes include polymyositis &#40;PM&#41;&#44; dermatomyositis &#40;DM&#41;&#44; immune-mediated necrotizing myopathy &#40;IMNM&#41;&#44; sporadic inclusion body myositis &#40;sIBM&#41; and the anti-synthetase syndrome &#40;ASS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">3&#44;4</span></a> A systematic review estimated the epidemiology of IIMs and found that the incidence of IIMs ranged from 1&#46;16 to 19&#47;1<span class="elsevierStyleHsp" style=""></span>000<span class="elsevierStyleHsp" style=""></span>000&#47;year and their prevalence ranged from 2&#46;4 to 33&#46;8 per 100<span class="elsevierStyleHsp" style=""></span>000 inhabitants&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">5</span></a> Though the rarity of IIMs has been determined&#44; as the poor overall prognosis of IIMs has been proved&#44; there is still a need to characterize patients&#8217; features and improve their prognoses&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The increased risk of cancer in patients with IIMs&#44; especially in adult dermatomyositis&#44; has long been recognized&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">6&#44;7</span></a> Prevalence of cancer in IIMs varies between 6&#46;7 and 32&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a> Myositis with cancer is often referred to as cancer-associated myositis &#40;CAM&#41;&#44; which is typically defined as the development of a malignancy within 3 years of the diagnosis of myositis &#40;before or after&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> In general&#44; the survival rate of the patients with malignancy is significantly lower than that of patients without&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">10</span></a> Additionally&#44; in comparison to those with cancer unrelated to myositis&#44; worse prognosis has also been determined in CAM&#44; with an age- and sex-adjusted Cox hazard ratio &#40;HR&#41; of 10&#46;8 &#40;95&#37; CI 1&#46;38&#8211;84&#46;5&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41; for all-cause mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">11</span></a> Clinical phenotypes of CAM differs from primary myositis&#46; Prognosis and life expectancy in CAM patients is mainly determined by the underlying malignant disease&#46; Therefore&#44; determining specific phenotypic characteristics that associated with an increased risk of cancer in IIMs can help identify patients who can benefit from targeted cancer screening&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In recent years&#44; some improvements have been made in searching biomarkers and in understanding the mechanisms of CAM&#46; Thereinto&#44; myositis-specific autoantibodies &#40;MSAs&#41; should be mentioned&#46; Though significant clinical heterogeneity of patients with IIMs is observed&#44; MSAs are detected uniquely in IIMs and can help to classify patients into more homogeneous groups&#46; For instance&#44; the most common MSAs reported to be associated with increased malignancy risk are anti-TIF1-&#947;&#44; anti-nuclear matrix protein-2 &#40;NXP-2&#41;&#44; anti-small ubiquitin-like modifier 1 activating enzyme &#40;SAE&#41;&#44; as well as anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase &#40;HMGCR&#41; antibodies&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">2&#44;8&#44;9</span></a> Though there are some studies that determine the clinical characteristics and prognoses of anti-TIF1-&#947; antibody positive IIM patients&#44; studies exploring prognostic features of anti-TIF1-&#947; antibody carrying IIM patients with&#47;without cancer are still needed&#46; Herein&#44; we retrospectively examined the correlations between different MSAs and cancer risk in Chinese IIM patients&#46; We also determined the clinical characteristics and prognoses of anti-TIF1-&#947; antibody positive IIM patients&#44; especially patients with malignancy&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients</span><p id="par0020" class="elsevierStylePara elsevierViewall">This retrospective study enrolled 312 patients with adult IIMs who were treated at the Department of Rheumatology and Immunology&#44; Tianjin Medical University General Hospital&#44; China&#44; from January 2015 to December 2020&#46; The enrolled patients fulfilled the criteria of Bohan and Peter myositis criteria for PM&#47;DM&#44;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">12&#44;13</span></a> the Sontheimer&#39;s criteria for clinically amyopathic DM &#40;CADM&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">14</span></a> the European Neuromuscular Center &#40;ENMC&#41; 2003 criteria for IMNM&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">15</span></a> and the Connors&#39;s criteria for ASS&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">16</span></a> respectively&#46; CAM was defined as the development of a malignancy within 3 years of the diagnosis of myositis &#40;before or after&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a> The study was approved by the ethics committee of the Tianjin Medical University General Hospital &#40;approval number&#58; IRB2021-YX-002-01&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data collecting and recording</span><p id="par0025" class="elsevierStylePara elsevierViewall">Patients&#8217; medical records were reviewed to obtain information about demographic and clinical data as well as cancer related data&#46; Demographic data included age&#44; gender&#44; disease duration&#46; Clinical data included fever &#40;&#62;37&#46;5<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#44; fatigue&#44; loss of body weight &#40;&#62;5&#37;&#41;&#44; cutaneous involvement&#44; proximal weakness&#44; serum level of creatine kinase &#40;CK&#41;&#44; myalgia&#44; arthritis&#47;arthralgia&#44; dysphagia&#44; dysarthria&#44; interstitial lung disease &#40;ILD&#41; and cancer&#46; Cutaneous manifestations of interest were mechanic&#39;s hands&#44; Gottron&#39;s sign&#47;papules&#44; heliotrope rash&#44; V sign&#44; shawl sign&#44; periungual erythema&#44; cutaneous ulcer&#46; ILD was diagnosed based on chest high resolution computer tomography&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">All the patients received tumor screening&#44; including computer tomography scan of chest&#44; abdomen and pelvis&#44; ultrasonic examination of thyroid&#44; superficial lymph nodes and breast&#46; Positron emission tomography&#47;computed tomography &#40;PET&#47;CT&#41; imaging was conducted in some patients&#46; For CAM patients&#44; the time of cancer diagnosis&#44; type of cancer&#44; the time of death were obtained through medical records or telephone interview&#46; For non-CAM patients&#44; the date of death&#44; which was determined by medical records or by telephone if the death occurred outside of the hospital&#44; was recorded&#46; The duration of follow-up was defined as the time from the first diagnosis until the date of death or December 2021 for survivor&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Assays for myositis-specific antibodies</span><p id="par0035" class="elsevierStylePara elsevierViewall">Serum MSAs including anti-Mi-2&#44; anti-TIF1-&#947;&#44; anti-NXP2&#44; anti-SAE&#44; anti-MDA5&#44; anti-SRP&#44; anti-Jo-1&#44; anti-PL-7&#44; anti-PL-12&#44; anti-OJ and anti-EJ antibodies were detected using line blot assay &#40;LB&#41; &#40;EUROIMMUN&#44; Germany&#41; according to the manufacturer&#39;s protocol&#46; Those with 2&#43; or more were considered positive in LB&#46; The anti-HMGCR autoantibody was detected using the ELISA assay &#40;Inova Diagnostics&#44; USA&#41; according to the manufacturer&#39;s protocol&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0040" class="elsevierStylePara elsevierViewall">For the description of quantitative data&#44; the normal distribution groups were described as the mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#44; and the skewed distribution groups were described by the median &#91;25th percentile&#44; 75th percentile&#93;&#44; whereas categorical variables were presented as number positive&#47;percentage&#46; Group comparisons were made using Student&#39;s <span class="elsevierStyleItalic">t</span> test &#40;quantitative data with normal distribution&#41;&#44; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test &#40;quantitative data with skewed distribution&#41;&#44; <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> statistics &#40;categorical data&#41;&#46; Cancer-associated MSAs was estimated through binary logistic regression analysis&#46; Survival was estimated using Kaplan&#8211;Meier curves&#59; results were compared using the log-rank test&#46; A <span class="elsevierStyleItalic">p</span> value of less than 0&#46;05 was considered statistically significant&#46; In certain condition&#44; the corrected <span class="elsevierStyleItalic">p</span> value was used&#46; All statistical analyses were performed using SPSS 20&#46;0 statistical software &#40;IBM&#41;&#46; All the graphs were performed using GraphPad Prism software 8&#46;0 for Windows &#40;GraphPad Software&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Overall patient characteristics</span><p id="par0045" class="elsevierStylePara elsevierViewall">The study enrolled 312 IIM patients&#44; consisting of 128 DM&#47;CADM&#44; 59 PM&#44; 111 ASS and 14 IMNM&#46; The cohort was mostly &#40;75&#46;32&#37;&#41; female with a mean age of 52&#46;90<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;94 years &#40;range 18&#8211;89 years&#41; at age of diagnosis&#46; The mean disease duration between onset and diagnosis was 16&#46;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>36&#46;51 months&#46; Their demographic&#44; clinical features were recorded in detail in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Of these 312 adult IIM patients&#44; serum MSAs were detected&#46; MSAs were found in 247 &#40;79&#46;17&#37;&#41; patients in the whole cohort&#44; including 52 with anti-Jo-1 antibody&#44; 45 with anti-MDA5 antibody&#44; 39 with anti-TIF1-&#947; antibody&#44; 29 with anti-EJ antibody&#44; 22 with anti-Mi-2 antibody&#44; 15 with anti-PL-7 antibody&#44; 12 with anti-SRP antibody&#44; 11 with anti-PL-12 antibody&#44; 9 with anti-NXP2 antibody&#44; 8 patients with anti-SAE antibody&#44; 4 with anti-OJ antibody&#44; 1 with anti-HMGCR antibody positive&#44; and the remaining 65 patients were MSAs-negative&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Anti-TIF1-&#947; antibody and anti-SAE antibody were cancer-associated autoantibodies</span><p id="par0050" class="elsevierStylePara elsevierViewall">Of 312 enrolled patients&#44; cancer was detected in 43 patients&#44; of whom 34 were CAMs&#46; In 4 out of 34 CAMs&#44; cancers were detected more than 3 years before IIMs diagnosis&#44; but 2 of them suffered tumor recur at the time of diagnosis of IIMs&#44; and the remaining 2 patients suffered newly growing cancers&#46; These 34 CAMs consisted of 25 DM&#47;CADM&#44; 5 ASS&#44; 4 PM&#46; In order to define the exact association between specific types of MSA and cancer&#44; serum MSAs were detected&#46; 34 CAMs included 15 of the 39 patients with anti-TIF1-&#947; antibody &#40;38&#46;46&#37;&#41;&#44; 5 of the 8 patients with anti-SAE antibody &#40;62&#46;50&#37;&#41;&#44; 3 of the 53 with anti-Jo-1 antibody &#40;5&#46;67&#37;&#41;&#44; 2 of 45 with anti-MDA5 antibody &#40;4&#46;44&#37;&#41;&#44; 1 of 10 patients with anti-NXP2 antibody &#40;10&#46;00&#37;&#41;&#44; 1 of 28 with anti-Mi-2 antibody &#40;3&#46;57&#37;&#41;&#44; 1 of 14 with anti-PL-12 antibody &#40;7&#46;14&#37;&#41;&#44; 1 of 29 with anti-EJ antibody &#40;3&#46;45&#37;&#41;&#44; as well as the remaining 5 patients with MSAs-negative&#46; Logistic regression analysis was further conducted to determine which specific MSA was cancer-associated autoantibody&#46; The results revealed that anti-TIF1-&#947; antibody and anti-SAE antibody were cancer-associated autoantibodies with odds ratios &#40;95&#37; CI&#41; of 8&#46;70 &#40;3&#46;35&#8211;22&#46;64&#41; and 22&#46;31 &#40;4&#46;32&#8211;115&#46;05&#41;&#44; respectively &#40;shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Baseline clinical features of IIM patients with anti-TIF1-&#947; antibody</span><p id="par0055" class="elsevierStylePara elsevierViewall">Given anti-TIF1-&#947; antibody was one the most common MSAs in our cohort and sample size of patients with anti-SAE antibody positive was too small&#44; we further compared the clinical characteristics between IIM patients with anti-TIF1-&#947; antibody and those without &#40;shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The results showed that patients with anti-TIF1-&#947; antibody had shorter duration between disease onset and diagnosis &#40;9&#46;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;96 <span class="elsevierStyleItalic">vs&#46;</span> 17&#46;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>38&#46;64&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41;&#46; Patients with anti-TIF1-&#947; antibody had a higher frequencies of skin lesions&#44; including heliotrope rash &#40;21&#47;53&#46;84&#37; <span class="elsevierStyleItalic">vs&#46;</span> 53&#47;19&#46;41&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#44; V sign &#40;27&#47;69&#46;23&#37; <span class="elsevierStyleItalic">vs&#46;</span> 69&#47;25&#46;27&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#44; shawl sign &#40;24&#47;61&#46;53&#37; <span class="elsevierStyleItalic">vs&#46;</span> 56&#47;20&#46;51&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; and periungual erythema &#40;6&#47;15&#46;38&#37; <span class="elsevierStyleItalic">vs&#46;</span> 12&#47;4&#46;39&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;010&#41;&#46; Compared with the anti-TIF1-&#947; antibody negative group&#44; the patients with positive anti-TIF1-&#947; antibody had higher frequencies of proximal weakness &#40;35&#47;89&#46;74&#37; <span class="elsevierStyleItalic">vs&#46;</span> 144&#47;52&#46;74&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#44; dysphagia &#40;17&#47;43&#46;58&#37; <span class="elsevierStyleItalic">vs&#46;</span> 60&#47;21&#46;97&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; and dysarthria &#40;6&#47;15&#46;38&#37; <span class="elsevierStyleItalic">vs&#46;</span> 17&#47;6&#46;22&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;040&#41;&#46; On the contrary&#44; patients with anti-TIF1-&#947; antibody had a lower frequencies of fever &#40;6&#47;15&#46;38&#37; <span class="elsevierStyleItalic">vs&#46;</span> 123&#47;45&#46;05&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#44; arthritis&#47;arthralgia &#40;5&#47;12&#46;82&#37; <span class="elsevierStyleItalic">vs&#46;</span> 120&#47;43&#46;95&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; and ILD &#40;20&#47;51&#46;28&#37; <span class="elsevierStyleItalic">vs&#46;</span> 206&#47;75&#46;46&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Characteristics of anti-TIF1-&#947; antibody-associated cancer</span><p id="par0060" class="elsevierStylePara elsevierViewall">Cancers were detected in 15 of the 39 patients with anti-TIF1-&#947; antibody&#44; of the remaining 24 patients&#44; 19 were still alive and did not develop any cancer during the median follow-up period of 52&#46;25 months&#46; In 2 out of 15 anti-TIF1-&#947; antibody-associated cancer patients&#44; cancers were detected in 4 and 5 years before IIMs diagnosis&#46; However&#44; their tumor recurred at the time of diagnosis of IIMs&#46; Therefore&#44; we still enrolled these 2 patients&#46; These 15 patients were predominantly female &#40;12&#47;80&#46;00&#37;&#41;&#46; As for temporal relationship between the onset of myositis and cancer diagnosis&#47;recurrence of the 15 anti-TIF1-&#947; antibody-associated CAMs&#44; cancers or cancer recurrences were detected in 80&#37; &#40;12&#47;15&#41; patients within 1 year around myositis diagnosis &#40;shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The most frequent cancer types in these 15 patients were ovary &#40;6&#41; and breast &#40;2&#41;&#46; Additionally&#44; cancer in lung&#44; liver&#44; thyroid&#44; stomach&#44; colon&#44; thymus and uterus were also detected&#46; The sites of cancers and gender distribution were summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The most frequent histopathologic types were high-grade serous carcinoma and adenocarcinoma&#46; Regarding cancer stages&#44; 8 &#40;53&#46;33&#37;&#41; patients were in an early stage &#40;I or II&#41; and 7 &#40;46&#46;67&#37;&#41; in an advanced stage &#40;III or IV&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Anti-TIF1-&#947; antibody was predictor of poor prognosis</span><p id="par0065" class="elsevierStylePara elsevierViewall">All patients were followed up for a median of 30 months &#40;range 0&#46;5&#8211;274 months&#41;&#44; during which 51 patients died&#46; As for patients with anti-TIF1-&#947; antibody positive&#44; 14 patients died with a median survival time of 9 months &#40;range 2&#8211;31 months&#41;&#46; The most common cause of death was tumor&#46; We further explored that whether the presence of anti-TIF1-&#947; antibody and cancer could influence the prognosis of patients&#46; The results showed that patients with anti-TIF1-&#947; antibody positive had significantly lower survival rates than the anti-TIF1-&#947; antibody negative group &#40;1-year survival&#44; 78&#46;2&#37; <span class="elsevierStyleItalic">vs&#46;</span> 90&#46;7&#37;&#59; 3-year survival&#44; 60&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 86&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46; Besides&#44; patients with CAM had significantly lower survival rates than the those without &#40;1-year survival&#44; 78&#46;0&#37; <span class="elsevierStyleItalic">vs&#46;</span> 90&#46;5&#37;&#59; 3-year survival&#44; 57&#46;3&#37; <span class="elsevierStyleItalic">vs&#46;</span> 85&#46;9&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; Further&#44; for anti-TIF1-&#947; antibody positive patients&#44; compared with patients without cancer&#44; patients with anti-TIF1-&#947; antibody associated CAM had worse prognosis &#40;1-year survival&#44; 65&#46;6&#37; <span class="elsevierStyleItalic">vs&#46;</span> 85&#46;3&#37;&#59; 3-year survival&#44; 40&#46;0&#37; <span class="elsevierStyleItalic">vs&#46;</span> 80&#46;4&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;024&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">In current study&#44; we described that anti-TIF1-&#947; antibody and anti-SAE antibody were two risk factor of CAM&#46; The association between anti-TIF1-&#947; antibody and cancer in IIMs has long been confirmed by a number of studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">11&#44;17</span></a> Recently&#44; a meta-analysis of 18 cohort studies estimated that the pooled prevalence of CAM in patients with anti-TIF1-&#947; antibody was 40&#46;7&#37; &#91;95&#37; confidence interval &#40;CI&#41; 0&#46;36&#8211;0&#46;45&#93;&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a> This was consistent with the prevalence of CAM in patients with anti-TIF1-&#947; antibodies in our cohort&#46; Given the high incidence of CAM in patients with anti-TIF1-&#947; antibody&#44; clarifying the links between tumorigenesis and anti-TIF1-&#947; antibody was necessary&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">In the past decade&#44; the link between autoimmunity and cancer has become a topic of continuous concern&#46; TIF1-&#947; was discovered in 1999 and identified as the third member of the TIF1 protein &#40;after TIF1-&#945; and TIF1-&#946;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a> TIF1-&#947; is involved in multiple critical biological processes&#46; The main interacting pathways of TIF1-&#947; are the Smad4-dependent canonical and Smad4-independent non-canonical TGF-&#946; pathways&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">19&#8211;21</span></a> Through its involvement in the TGF-&#946; pathway&#44; TIF1-&#947; inhibits tumorigenesis mainly by inhibition of TGF-&#946;-induced epithelial-to-mesenchymal transition <span class="elsevierStyleItalic">via</span> mono-ubiquitination of SMAD4&#46; Inactivation&#44; mutation or downregulation of TIF1-&#947; can all result in a reduction of this effect and thus promote tumorigenesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">2&#44;8&#44;22&#44;23</span></a> Based on these researches&#44; hypothetical model of links between autoimmunity and cancer had been proposed&#46; Altered TIF1-&#947; antigens in tumors may provoke a specific antitumoral immune response which may secondarily extend to the target organs of myositis &#40;muscle&#44; skin&#41; by cross-reactivity&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">2&#44;8</span></a> Non-specific injury of muscle and skin cells can lead to regeneration with high levels of wild-type TIF1-&#947; autoantigen&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">2&#44;8</span></a> Additionally&#44; a genetic predisposition can explain why not all cancers with altered TIF1-&#947; expression lead to myositis&#46;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">24&#44;25</span></a> Importantly&#44; Dani reported that anti-TIF1-&#947; antibodies may be detected before clinical symptoms of cancer and may disappear after successful treatment of cancer along with remission of IIMs&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">26</span></a> Changed serum levels of anti-TIF1-&#947; antibodies in this longitudinal study supported the hypothesis mentioned above&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In our cohort&#44; the most frequent types of cancer occurred in anti-TIF1-&#947; positive patients were ovarian and breast cancer&#46; Given anti-TIF1-&#947; positive CAM patients were female-dominant&#44; this was comparable with those in the general female population in China&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">27</span></a> The distribution of detected cancer sites in this study was similar to that in other cohorts in China<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">11&#44;28</span></a> and in Northern Europe&#44;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">29</span></a> while gastric cancer &#40;8&#47;23&#41; was the most common malignancy in Japan&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">30</span></a> Consistently&#44; in one cohort of patients with DM&#44; ovarian cancer was significantly more present in anti-TIF1-&#947;-positive patients than anti-TIF1-&#947; negative patients&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">31</span></a> Additionally&#44; all of the cancers in our cohort were solid cancers&#44; no hematological malignancies were observed&#46; However&#44; in Oldroyd&#39;s cohort in the UK&#44; other than breast and ovarian cancer&#44; lymphoma was reported to be the third most common malignancy in anti-TIF1-&#947; positive cohort&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">31</span></a> It is not clear whether the difference of the types of cancer between different regions is because of diet habit&#44; geographic environment as well as ethnical differences&#46; Further study of a large population will be necessary to determine whether any specific cancer type is associated with the anti-TIF1-&#947; antibody&#46; CAM has poor prognosis and causes higher mortality&#46; Poor prognosis of CAM patients&#44; especially subset with anti-TIF1-&#947; antibody positive&#44; was observed in our study&#46; Older age&#44; severe cutaneous and muscle symptoms were observed significantly more commonly in patients with CAM&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">28&#44;32</span></a> Heliotrope rash&#44; shawl sign and V sign had already been observed more commonly in patients with CAM&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">28&#44;33&#44;34</span></a> Compared with anti-TIF1-&#947; antibody negative patients&#44; patients with positive anti-TIF1-&#947; antibody have a higher frequencies of these cutaneous manifestations in our cohort&#46; Additionally&#44; dysphagia at onset was another feature of CAM&#44;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">35</span></a> which was consistent with higher frequencies of dysphagia in patients with positive anti-TIF1-&#947; antibody&#46; Therefore&#44; patients with these cutaneous features should receive intensive malignancy screening&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">In our study&#44; the mortality rate of CAM patients was significantly higher than non-CAM patients&#46; This result was consistent with previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">10&#44;28</span></a> Besides&#44; patients with anti-TIF1-&#947; antibody associated cancer had worst prognosis&#46; The main cause of death for CAM patients in this study was malignancy&#46; Higher mortality rate of CAM patients with advanced tumor stages were observed&#46; Therefore&#44; prognosis and life expectancy in CAM patients is determined by the underlying malignant disease&#46; Considering that anti-TIF1-antibody-positive associated malignancy occurred exclusively within 3 years either side of the dermatomyositis onset&#44; and no incident cancer cases were detected in this group beyond this period&#44;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">31</span></a> yearly cancer screening &#40;conventional or with PET&#47;CT&#41; is recommended in anti-TIF1-&#947;-positive patients for at least 3&#8211;5 years after diagnosis&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Autoantibodies against the SAE &#40;small ubiquitin-like modifier &#40;SUMO&#41; activating enzyme&#41; were first reported in 2007 by Betteridge et al&#46;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">36</span></a> Since the first report of anti SAE antibodies in DM cases&#44; the prevalence of anti-SAE antibody was described by several different cohorts&#44; ranging from 1&#37; to 8&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">37&#8211;40</span></a> This was consistent with the frequency of anti-SAE antibodies &#40;2&#46;6&#37;&#41; in our cohort&#46; It has been reported that anti-SAE positive is associated with widespread skin involvement&#44; muscle involvement&#44; ILD and dysphagia&#46;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">38&#44;40&#44;41</span></a> However&#44; the incidence of cancer in anti-SAE positive IIMs varied per cohort&#46; Previous studies reported the frequency of cancer in anti-SAE-positive patients as 14&#8211;57&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">37&#44;39&#44;42&#44;43</span></a> In our cohort&#44; the frequency of cancer in anti-SAE positive patients was 62&#46;5&#37;&#46; Logistic regression analysis revealed that anti-SAE antibody was cancer-associated autoantibodies with odds ratios &#40;95&#37; CI&#41; of 22&#46;31 &#40;4&#46;32&#8211;115&#46;05&#41;&#46; Multivariate analysis using a large cohort will be needed to clarify the association between anti-SAE antibodies and cancers&#46; In clinical practice&#44; risk of malignancy should be considered in anti-SAE antibody positive patients&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">There are several limitations in our study&#46; First&#44; in this retrospective study&#44; a patient selection bias cannot be avoided due to all data being collected from inpatient medical records in a single tertiary referral center&#46; Second&#44; the relatively small sample of patients with cancer makes it very difficult to draw firm conclusion on determining cancer-associated autoantibodies and their clinical features&#46; Third&#44; we used the one kind of method to detect the MSAs&#44; and did not perform immunoprecipitation &#40;IP&#41;-western blotting &#40;WB&#41; assays to further confirm the specificities of these antibodies&#46; The possible false positive or negative results might have led to potential for bias&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conclusions</span><p id="par0100" class="elsevierStylePara elsevierViewall">In current study&#44; our results showed that anti-TIF1-&#947; antibody and anti-SAE antibody were cancer-associated autoantibodies&#46; Our study showed that anti-TIF1-&#947; antibody positive CAM was a subset that comprised about half of CAM entities and had the characteristic of close temporal association with cancer detection&#47;recurrence&#46; The presence of anti-TIF1-&#947; antibody was associated with CAM&#46; Prognosis and life expectancy in CAM patients is mainly determined by the underlying malignant disease&#46; Therefore&#44; rigorous screening for malignancy is important in patients with anti-TIF1-&#947; antibody&#46; Additionally&#44; risk of malignancy should be considered in anti-SAE antibody positive patients&#46; Further studies are necessary to evaluate the biological links between cancer-associated MSAs and malignancy in IIMs&#46; Only after we deeply understand the mechanism of tumorigenesis in IIMs&#44; can we apply these new insights to patients and improve their prognosis&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Competing interests</span><p id="par0105" class="elsevierStylePara elsevierViewall">Authors have declared that no conflict interests exist&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Author&#39;s contributions</span><p id="par0110" class="elsevierStylePara elsevierViewall">W&#46;W&#46; and Y&#46;Z&#46; designed the overall study&#46; Y&#46;Z&#46; drafted the first manuscript&#46; Y&#46;Z&#46; analyzed data&#59; H&#46;H&#46; detected MSAs&#59; Y&#46;Z&#46;&#44; Y&#46;H&#46;S&#44; X&#46;Y&#46;Y&#44; and Y&#46;A&#46;W&#46; collected data&#59; Y&#46;H&#46;S&#46;&#44; X&#46;Y&#46;Y&#46; and Y&#46;X&#46; telephoned the patients to collect survival data&#59; X&#46;L&#46;&#44; W&#46;W&#46;S&#46;&#44; N&#46;Z&#46; guided clinical diagnosis and treatment&#59; W&#46;W&#46;&#44; and N&#46;Z&#46; made the critical revision of the manuscript&#44; and finalized the article&#46; All authors critically contributed to the manuscript for important intellectual content&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Funding</span><p id="par0115" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:14 [
        0 => array:3 [
          "identificador" => "xres1829148"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1594683"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1829147"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1594684"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patients"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Data collecting and recording"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Assays for myositis-specific antibodies"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0035"
          "titulo" => "Results"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Overall patient characteristics"
            ]
            1 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Anti-TIF1-&#947; antibody and anti-SAE antibody were cancer-associated autoantibodies"
            ]
            2 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Baseline clinical features of IIM patients with anti-TIF1-&#947; antibody"
            ]
            3 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Characteristics of anti-TIF1-&#947; antibody-associated cancer"
            ]
            4 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Anti-TIF1-&#947; antibody was predictor of poor prognosis"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Competing interests"
        ]
        10 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Author&#39;s contributions"
        ]
        11 => array:2 [
          "identificador" => "sec0085"
          "titulo" => "Funding"
        ]
        12 => array:2 [
          "identificador" => "xack645213"
          "titulo" => "Acknowledgements"
        ]
        13 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-02-12"
    "fechaAceptado" => "2022-03-29"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1594683"
          "palabras" => array:4 [
            0 => "Anti-TIF1-&#947; antibody"
            1 => "Idiopathic inflammatory myopathy"
            2 => "Cancer"
            3 => "Prognosis"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1594684"
          "palabras" => array:4 [
            0 => "Anticuerpo anti-TIF1-&#947;"
            1 => "Miopat&#237;a inflamatoria idiop&#225;tica"
            2 => "C&#225;ncer"
            3 => "Pron&#243;stico"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Idiopathic inflammatory myopathies &#40;IIMs&#41; are systemic&#44; heterogeneous diseases&#44; which mainly affect skeletal muscle&#46; Myositis with cancer is often referred to as cancer-associated myositis &#40;CAM&#41;&#44; which is associated with poor prognosis&#46; This study aimed to determine the cancer associated myositis-specific autoantibodies &#40;MSAs&#41; and to elucidate their associations with clinical features in Chinese patients with IIMs&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This retrospective study enrolled 312 patients with IIMs who were treated at Tianjin Medical University General Hospital&#44; China&#44; from January 2015 to December 2020&#46; Clinical data were collected&#46; Serum MSAs&#44; including anti-Mi-2&#44; anti-TIF1-&#947;&#44; anti-NXP2&#44; anti-SAE&#44; anti-MDA5&#44; anti-SRP&#44; anti-Jo-1&#44; anti-PL-7&#44; anti-PL-12&#44; anti-OJ&#44; anti-EJ and anti-HMGCR antibodies were detected&#46; Cancer-associated MSAs&#44; their phenotypic and survival features were estimated through SPSS 20&#46;0&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The results revealed that anti-TIF1-&#947; antibody and anti-SAE antibody were cancer-associated autoantibodies with odds ratios &#40;95&#37; CI&#41; of 8&#46;70 &#40;3&#46;35&#8211;22&#46;64&#41; and 22&#46;31 &#40;4&#46;32&#8211;115&#46;05&#41;&#44; respectively&#46; Skin lesions&#44; proximal weakness&#44; dysphagia and dysarthria were observed more frequently in patients carrying anti-TIF1-&#947; antibody&#46; By contrast&#44; patients with anti-TIF1-&#947; antibody had a lower frequencies of fever&#44; arthritis&#47;arthralgia and interstitial lung disease &#40;ILD&#41;&#46; Anti-TIF1-&#947; antibody positive CAM comprised about half of CAM entities and had the characteristic of close temporal association with cancer detection&#47;recurrence&#46; Female-dominant&#44; common reproductive system tumors were other clinical features of this subset&#46; Besides&#44; patients with anti-TIF1-&#947; antibody positive had significantly lower survival rates than the anti-TIF1-&#947; antibody negative group&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Anti-TIF1-&#947; antibody and anti-SAE antibody were cancer-associated autoantibodies&#46; Anti-TIF1-&#947; antibody positive CAM was a subset that comprised about half of CAM entities and had the characteristic of poor prognosis&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La miopat&#237;a inflamatoria idiop&#225;tica &#40;IIM&#44; por sus siglas en ingl&#233;s&#41; es una enfermedad sist&#233;mica y heterog&#233;nea que afecta principalmente al m&#250;sculo esquel&#233;tico&#46; La miositis asociada al c&#225;ncer se denomina a menudo miositis relacionada con el c&#225;ncer&#44; y est&#225; relacionada con un mal pron&#243;stico&#46; El objetivo de este estudio fue identificar autoanticuerpos espec&#237;ficos de miositis relacionados con el c&#225;ncer en pacientes chinos&#44; y dilucidar su correlaci&#243;n con las caracter&#237;sticas cl&#237;nicas&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El estudio retrospectivo incluy&#243; a 312 pacientes con IIM tratados en el hospital general de la Universidad M&#233;dica de Tianjin&#44; China&#44; de enero de 2015 a diciembre de 2020&#46; Recoger datos cl&#237;nicos&#46; Se detectaron autoanticuerpos espec&#237;ficos de miositis s&#233;rica&#44; incluyendo anti-Mi-2&#44; anti-TIF1-&#947;&#44; anti-NXP2&#44; anti-SAE&#44; anti-MDA5&#44; anti-SRP&#44; anti-Jo-1&#44; anti-PL-7&#44; anti-PL-12&#44; anti-OJ&#44; anti-EJ&#44; anti-HMGCR&#46; Los autoanticuerpos relacionados con el c&#225;ncer&#44; sus fenotipos y sus caracter&#237;sticas de supervivencia fueron evaluados por SPSS&#174; 20&#46;0&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los resultados mostraron que el anticuerpo anti-TIF1-&#947; y el anticuerpo anti-SAE eran autoanticuerpos relacionados con el c&#225;ncer con una relaci&#243;n de predominio &#40;IC 95&#37;&#41; de 8&#44;70 &#40;3&#44;35&#8211;22&#44;64&#41; y 22&#44;31 &#40;4&#44;32&#8211;115&#44;05&#41;&#44; respectivamente&#46; La frecuencia de lesiones cut&#225;neas&#44; debilidad proximal&#44; disfagia y disartria fue mayor en los pacientes portadores de anticuerpos anti-TIF1-&#947;&#46; En comparaci&#243;n&#44; la incidencia de fiebre&#44; artritis&#47;artralgia y enfermedad pulmonar intersticial &#40;ILD&#41; en pacientes con anticuerpos anti-TIF1-&#947; fue menor&#46; La miositis relacionada con el c&#225;ncer con anticuerpos anti-TIF1-&#947; positivos representa aproximadamente la mitad de la miositis relacionada con el c&#225;ncer y tiene caracter&#237;sticas temporales estrechamente relacionadas con la detecci&#243;n&#47;recidiva del c&#225;ncer&#46; Los tumores del sistema reproductivo que predominan en las mujeres son otras caracter&#237;sticas cl&#237;nicas de este subgrupo&#46; Adem&#225;s&#44; la tasa de supervivencia de los pacientes con anticuerpos anti-TIF1-&#947; positivos fue significativamente menor que la del grupo anti-TIF1-&#947; negativo&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los anticuerpos anti-TIF1-&#947; y anti-SAE son autoanticuerpos relacionados con el tumor&#46; Los pacientes con anticuerpos anti-TIF1-&#947; positivos son un subgrupo&#44; que representa aproximadamente la mitad de los pacientes con miositis relacionada con el c&#225;ncer&#44; y tienen un mal pron&#243;stico&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 992
            "Ancho" => 1258
            "Tamanyo" => 69993
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Temporal relationship between the onset of IIMs and cancer diagnosis within anti-TIF1-&#947;-positive patients&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1853
            "Ancho" => 2508
            "Tamanyo" => 237730
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Cumulative survival rates for patients with IIMs&#46; &#40;A&#41; Comparison between patients with anti-TIF1-&#947; antibody and patients without&#46; &#40;B&#41; Comparison between CAMs and those non-CAMs&#46; &#40;C&#41; Comparison between anti-TIF1-&#947; antibody positive CAMs and those anti-TIF1-&#947; antibody positive patients without cancer&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">p</span> value&#58; anti-TIF1 &#947;-positive subgroup <span class="elsevierStyleItalic">vs&#46;</span> anti-TIF1 &#947;-negative subgroup&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Total subjects&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Anti-TIF1 &#947;-positive&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Anti-TIF1 &#947;-negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span> value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>312&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>273&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Demographic</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sex&#44; female&#47;male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">235&#47;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#47;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">204&#47;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Age of onset&#44; years&#44; mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;90<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#46;38<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Delay between onset and diagnosis&#44; months&#44; mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>36&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>38&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;05</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">General condition&#44; no&#46; &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">129 &#40;41&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;15&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">123 &#40;45&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fatigue&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213 &#40;68&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;76&#46;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">183 &#40;67&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Loss of weight &#40;&#62;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;26&#46;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;33&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;26&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Skin changes&#44; no&#46; &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Skin lesions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">202 &#40;64&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;92&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">166 &#40;60&#46;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanic&#39;s hands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;28&#46;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;10&#46;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;16&#46;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gottron&#39;s sign&#47;papules&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">106 &#40;33&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;41&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;32&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heliotrope rash&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;23&#46;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;53&#46;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;19&#46;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>V sign&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;30&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;69&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;25&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Shawl sign&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;25&#46;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;61&#46;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56 &#40;20&#46;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Periungual erythema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;5&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;15&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;4&#46;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;05</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Skin ulcers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;7&#46;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;12&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;6&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Extra-cutaneous manifestations</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Proximal weakness&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;57&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;89&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">144 &#40;52&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Myalgia&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">127 &#40;40&#46;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;46&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109 &#40;39&#46;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Increased CK levels&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">181 &#40;58&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;51&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161 &#40;58&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CK level&#44; U&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2081&#46;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5601&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1667&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3250&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2140&#46;07<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5863&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arthritis&#47;arthralgia&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">125 &#40;40&#46;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;12&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120 &#40;43&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dysphagia&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;24&#46;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;43&#46;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;21&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dysarthria&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;7&#46;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;15&#46;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;6&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;05</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ILD&#44; no&#46; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">226 &#40;72&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;51&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">206 &#40;75&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Prognosis&#44; no&#46; &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Death&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51 &#40;16&#46;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;35&#46;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;13&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Malignancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;10&#46;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;38&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;6&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Comparison of clinical and laboratory characteristics between anti-TIF1 &#947;-positive and negative patients&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-TIF1-&#947; antibody&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;35&#8211;22&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-SAE antibody&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;32&#8211;115&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Logistic regression analysis to determine the cancer-associated autoantibody&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Site of cancer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&#46; of cancers</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Total&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ovary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Breast&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lung&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Liver&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thyroid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stomach&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Colon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thymus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uterus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Site of cancer in anti-TIF1-&#947; antibody-positive patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>15&#41;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:43 [
            0 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "NIH conference&#46; Myositis&#58; immunologic contributions to understanding cause&#44; pathogenesis&#44; and therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;H&#46; Plotz"
                            1 => "L&#46;G&#46; Rider"
                            2 => "I&#46;N&#46; Targoff"
                            3 => "N&#46; Raben"
                            4 => "T&#46;P&#46; O&#8217;Hanlon"
                            5 => "F&#46;W&#46; Miller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-122-9-199505010-00010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1995"
                        "volumen" => "122"
                        "paginaInicial" => "715"
                        "paginaFinal" => "724"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7702234"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anti-TIF1-&#947; autoantibodies&#58; warning lights of a tumour autoantigen"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; De Vooght"
                            1 => "J&#46;B&#46; Vulsteke"
                            2 => "P&#46; De Haes"
                            3 => "X&#46; Bossuyt"
                            4 => "R&#46; Lories"
                            5 => "E&#46; De Langhe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/kez572"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2020"
                        "volumen" => "59"
                        "paginaInicial" => "469"
                        "paginaFinal" => "477"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31883334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of a new classification system for idiopathic inflammatory myopathies based on clinical manifestations and myositis-specific autoantibodies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Mariampillai"
                            1 => "B&#46; Granger"
                            2 => "D&#46; Amelin"
                            3 => "M&#46; Guiguet"
                            4 => "E&#46; Hachulla"
                            5 => "F&#46; Maurier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamaneurol.2018.2598"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Neurol"
                        "fecha" => "2018"
                        "volumen" => "75"
                        "paginaInicial" => "1528"
                        "paginaFinal" => "1537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30208379"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2017 European League Against Rheumatism&#47;American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;E&#46; Lundberg"
                            1 => "A&#46; Tj&#228;rnlund"
                            2 => "M&#46; Bottai"
                            3 => "V&#46;P&#46; Werth"
                            4 => "C&#46; Pilkington"
                            5 => "M&#46; Visser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2017-211468"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2017"
                        "volumen" => "76"
                        "paginaInicial" => "1955"
                        "paginaFinal" => "1964"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29079590"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and prevalence of inflammatory myopathies&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Meyer"
                            1 => "N&#46; Meyer"
                            2 => "M&#46; Schaeffer"
                            3 => "J&#46;E&#46; Gottenberg"
                            4 => "B&#46; Geny"
                            5 => "J&#46; Sibilia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/keu289"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "50"
                        "paginaFinal" => "63"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25065005"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer risk in dermatomyositis&#58; a meta-analysis of cohort studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;M&#46; Olazagasti"
                            1 => "P&#46;J&#46; Baez"
                            2 => "D&#46;A&#46; Wetter"
                            3 => "F&#46;C&#46; Ernste"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40257-015-0120-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Dermatol"
                        "fecha" => "2015"
                        "volumen" => "16"
                        "paginaInicial" => "89"
                        "paginaFinal" => "98"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25721032"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk of malignancy in dermatomyositis and polymyositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;K&#46; Qiang"
                            1 => "W&#46;B&#46; Kim"
                            2 => "A&#46; Baibergenova"
                            3 => "R&#46; Alhusayen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/1203475416665601"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cutan Med Surg"
                        "fecha" => "2017"
                        "volumen" => "21"
                        "paginaInicial" => "131"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27534779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatomyositis and immune-mediated necrotizing myopathies&#58; a window on autoimmunity and cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Aussy"
                            1 => "O&#46; Boyer"
                            2 => "N&#46; Cordel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fimmu.2017.00992"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Immunol"
                        "fecha" => "2017"
                        "volumen" => "8"
                        "paginaInicial" => "992"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28871260"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of cancer-associated autoantibodies as biomarkers in paraneoplastic myositis syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "X&#46; Lu"
                            1 => "Q&#46; Peng"
                            2 => "G&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/BOR.0000000000000641"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Rheumatol"
                        "fecha" => "2019"
                        "volumen" => "31"
                        "paginaInicial" => "643"
                        "paginaFinal" => "649"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31369431"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics and prognosis of polymyositis and dermatomyositis associated with malignancy&#58; a 25-year retrospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Motomura"
                            1 => "H&#46; Yamashita"
                            2 => "S&#46; Yamada"
                            3 => "Y&#46; Takahashi"
                            4 => "H&#46; Kaneko"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00296-019-04428-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "2019"
                        "volumen" => "39"
                        "paginaInicial" => "1733"
                        "paginaFinal" => "1739"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31444556"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of multiple cancer-associated myositis-specific autoantibodies in idiopathic inflammatory myopathies&#58; a large longitudinal cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Yang"
                            1 => "Q&#46; Peng"
                            2 => "L&#46; Yin"
                            3 => "S&#46; Li"
                            4 => "J&#46; Shi"
                            5 => "Y&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13075-017-1469-8"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Res Ther"
                        "fecha" => "2017"
                        "volumen" => "19"
                        "paginaInicial" => "259"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29178913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polymyositis and dermatomyositis &#40;first of two parts&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Bohan"
                            1 => "J&#46;B&#46; Peter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM197502132920706"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1975"
                        "volumen" => "292"
                        "paginaInicial" => "344"
                        "paginaFinal" => "347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1090839"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polymyositis and dermatomyositis &#40;second of two parts&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Bohan"
                            1 => "J&#46;B&#46; Peter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1975"
                        "volumen" => "292"
                        "paginaInicial" => "403"
                        "paginaFinal" => "407"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Would a new name hasten the acceptance of amyopathic dermatomyositis &#40;dermatomyositis sin&#233; myositis&#41; as a distinctive subset within the idiopathic inflammatory dermatomyopathies spectrum of clinical illness&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;D&#46; Sontheimer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mjd.2002.120621"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2002"
                        "volumen" => "46"
                        "paginaInicial" => "626"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11907524"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "119th ENMC international workshop&#58; trial design in adult idiopathic inflammatory myopathies&#44; with the exception of inclusion body myositis&#44; 10&#8211;12 October 2003&#44; Naarden&#44; The Netherlands"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;E&#46; Hoogendijk"
                            1 => "A&#46;A&#46; Amato"
                            2 => "B&#46;R&#46; Lecky"
                            3 => "E&#46;H&#46; Choy"
                            4 => "I&#46;E&#46; Lundberg"
                            5 => "M&#46;R&#46; Rose"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.nmd.2004.02.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuromuscul Disord"
                        "fecha" => "2004"
                        "volumen" => "14"
                        "paginaInicial" => "337"
                        "paginaFinal" => "345"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15099594"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Interstitial lung disease associated with the idiopathic inflammatory myopathies&#58; what progress has been made in the past 35 years&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;R&#46; Connors"
                            1 => "L&#46; Christopher-Stine"
                            2 => "C&#46;V&#46; Oddis"
                            3 => "S&#46;K&#46; Danoff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.10-0180"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2010"
                        "volumen" => "138"
                        "paginaInicial" => "1464"
                        "paginaFinal" => "1474"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21138882"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of anti-transcriptional intermediary factor-1 gamma autoantibody in identifying adult dermatomyositis patients with cancer&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Best"
                            1 => "N&#46; Molinari"
                            2 => "F&#46; Chasset"
                            3 => "T&#46; Vincent"
                            4 => "N&#46; Cordel"
                            5 => "D&#46; Bessis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2340/00015555-3091"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol"
                        "fecha" => "2019"
                        "volumen" => "99"
                        "paginaInicial" => "256"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30460368"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "TIF1gamma&#44; a novel member of the transcriptional intermediary factor 1 family"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Venturini"
                            1 => "J&#46; You"
                            2 => "M&#46; Stadler"
                            3 => "R&#46; Galien"
                            4 => "V&#46; Lallemand"
                            5 => "M&#46;H&#46; Koken"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.onc.1202655"
                      "Revista" => array:6 [
                        "tituloSerie" => "Oncogene"
                        "fecha" => "1999"
                        "volumen" => "18"
                        "paginaInicial" => "1209"
                        "paginaFinal" => "1217"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10022127"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recruitment of TIF1&#947; to chromatin via its PHD finger-bromodomain activates its ubiquitin ligase and transcriptional repressor activities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Agricola"
                            1 => "R&#46;A&#46; Randall"
                            2 => "T&#46; Gaarenstroom"
                            3 => "S&#46; Dupont"
                            4 => "C&#46;S&#46; Hill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.molcel.2011.05.020"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mol Cell"
                        "fecha" => "2011"
                        "volumen" => "43"
                        "paginaInicial" => "85"
                        "paginaFinal" => "96"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21726812"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dynamic regulation of Tgf-B signaling by Tif1&#947;&#58; a computational approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Andrieux"
                            1 => "L&#46; Fattet"
                            2 => "M&#46; Le Borgne"
                            3 => "R&#46; Rimokh"
                            4 => "N&#46; Th&#233;ret"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0033761"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS ONE"
                        "fecha" => "2012"
                        "volumen" => "7"
                        "paginaInicial" => "e33761"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22461896"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Regulation of TGF-&#946; signal transduction by mono- and deubiquitylation of Smads"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Dupont"
                            1 => "M&#46; Inui"
                            2 => "S&#46;J&#46; Newfeld"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.febslet.2012.03.037"
                      "Revista" => array:6 [
                        "tituloSerie" => "FEBS Lett"
                        "fecha" => "2012"
                        "volumen" => "586"
                        "paginaInicial" => "1913"
                        "paginaFinal" => "1920"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22710170"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reduced expression of transcriptional intermediary factor 1 gamma promotes metastasis and indicates poor prognosis of hepatocellular carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46;Y&#46; Ding"
                            1 => "G&#46;N&#46; Jin"
                            2 => "W&#46; Wang"
                            3 => "W&#46;X&#46; Chen"
                            4 => "Y&#46;H&#46; Wu"
                            5 => "X&#46; Ai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/hep.27273"
                      "Revista" => array:6 [
                        "tituloSerie" => "Hepatology"
                        "fecha" => "2014"
                        "volumen" => "60"
                        "paginaInicial" => "1620"
                        "paginaFinal" => "1636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24954480"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Repression of TIF1&#947; by SOX2 promotes TGF-&#946;-induced epithelial-mesenchymal transition in non-small-cell lung cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Wang"
                            1 => "H&#46; Yang"
                            2 => "Z&#46; Lei"
                            3 => "J&#46; Zhao"
                            4 => "Y&#46; Chen"
                            5 => "P&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/onc.2015.141"
                      "Revista" => array:6 [
                        "tituloSerie" => "Oncogene"
                        "fecha" => "2016"
                        "volumen" => "35"
                        "paginaInicial" => "867"
                        "paginaFinal" => "877"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25961934"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Focused HLA analysis in Caucasians with myositis identifies significant associations with autoantibody subgroups"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Rothwell"
                            1 => "H&#46; Chinoy"
                            2 => "J&#46;A&#46; Lamb"
                            3 => "F&#46;W&#46; Miller"
                            4 => "L&#46;G&#46; Rider"
                            5 => "L&#46;R&#46; Wedderburn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2019-215046"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2019"
                        "volumen" => "78"
                        "paginaInicial" => "996"
                        "paginaFinal" => "1002"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31138531"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A novel autoantibody to a 155-kd protein is associated with dermatomyositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46;N&#46; Targoff"
                            1 => "G&#46; Mamyrova"
                            2 => "E&#46;P&#46; Trieu"
                            3 => "O&#46; Perurena"
                            4 => "B&#46; Koneru"
                            5 => "T&#46;P&#46; O&#8217;Hanlon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.22164"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2006"
                        "volumen" => "54"
                        "paginaInicial" => "3682"
                        "paginaFinal" => "3689"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17075819"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anti-transcriptional intermediary factor 1 gamma antibodies in cancer-associated myositis&#58; a longitudinal study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Dani"
                            1 => "M&#46; Holmqvist"
                            2 => "M&#46;A&#46; Mart&#237;nez"
                            3 => "E&#46; Trallero-Araguas"
                            4 => "M&#46; Dastmalchi"
                            5 => "J&#46; Svensson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2020"
                        "volumen" => "38"
                        "paginaInicial" => "67"
                        "paginaFinal" => "73"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31365334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer statistics in China&#44; 2015"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Chen"
                            1 => "R&#46; Zheng"
                            2 => "P&#46;D&#46; Baade"
                            3 => "S&#46; Zhang"
                            4 => "H&#46; Zeng"
                            5 => "F&#46; Bray"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3322/caac.21338"
                      "Revista" => array:6 [
                        "tituloSerie" => "CA Cancer J Clin"
                        "fecha" => "2016"
                        "volumen" => "66"
                        "paginaInicial" => "115"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26808342"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for cancer-associated myositis&#58; a large-scale multicenter cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Li"
                            1 => "X&#46; Jia"
                            2 => "X&#46; Sun"
                            3 => "L&#46; Shi"
                            4 => "F&#46; Lin"
                            5 => "Y&#46; Gan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1756-185X.14046"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Rheum Dis"
                        "fecha" => "2021"
                        "volumen" => "24"
                        "paginaInicial" => "268"
                        "paginaFinal" => "273"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33369084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency of specific cancer types in dermatomyositis and polymyositis&#58; a population-based study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;L&#46; Hill"
                            1 => "Y&#46; Zhang"
                            2 => "B&#46; Sigurgeirsson"
                            3 => "E&#46; Pukkala"
                            4 => "L&#46; Mellemkjaer"
                            5 => "A&#46; Airio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(00)03540-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "357"
                        "paginaInicial" => "96"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11197446"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and predictive factors for malignancies in 136 Japanese patients with dermatomyositis&#44; polymyositis and clinically amyopathic dermatomyositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Azuma"
                            1 => "H&#46; Yamada"
                            2 => "M&#46; Ohkubo"
                            3 => "Y&#46; Yamasaki"
                            4 => "M&#46; Yamasaki"
                            5 => "M&#46; Mizushima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Mol Rheumatol"
                        "fecha" => "2011"
                        "volumen" => "21"
                        "paginaInicial" => "178"
                        "paginaFinal" => "183"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The temporal relationship between cancer and adult onset anti-transcriptional intermediary factor 1 antibody-positive dermatomyositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Oldroyd"
                            1 => "J&#46;C&#46; Sergeant"
                            2 => "P&#46; New"
                            3 => "N&#46;J&#46; McHugh"
                            4 => "Z&#46; Betteridge"
                            5 => "J&#46;A&#46; Lamb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/key357"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2019"
                        "volumen" => "58"
                        "paginaInicial" => "650"
                        "paginaFinal" => "655"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30535395"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer-associated myositis&#58; clinical features and prognostic signs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Ponyi"
                            1 => "T&#46; Constantin"
                            2 => "M&#46; Garami"
                            3 => "C&#46; Andr&#225;s"
                            4 => "B&#46; T&#225;llai"
                            5 => "A&#46; V&#225;ncsa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1196/annals.1361.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann N Y Acad Sci"
                        "fecha" => "2005"
                        "volumen" => "1051"
                        "paginaInicial" => "64"
                        "paginaFinal" => "71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16126945"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Retrospective analysis of cancer-associated myositis patients over the past 3 decades in a hungarian myositis cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Andr&#225;s"
                            1 => "L&#46; Bodoki"
                            2 => "M&#46; Nagy-Vincze"
                            3 => "Z&#46; Griger"
                            4 => "E&#46; Csiki"
                            5 => "K&#46; Dank&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12253-019-00756-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pathol Oncol Res"
                        "fecha" => "2020"
                        "volumen" => "26"
                        "paginaInicial" => "1749"
                        "paginaFinal" => "1755"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31646426"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical characteristics of cancer-associated myositis complicated by interstitial lung disease&#58; a large-scale multicentre cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Kaneko"
                            1 => "T&#46; Nunokawa"
                            2 => "Y&#46; Taniguchi"
                            3 => "Y&#46; Yamaguchi"
                            4 => "T&#46; Gono"
                            5 => "K&#46; Masui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/kez238"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2020"
                        "volumen" => "59"
                        "paginaInicial" => "112"
                        "paginaFinal" => "119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31382295"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cancer-associated myositis&#58; a 35-year retrospective study of a monocentric cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Neri"
                            1 => "S&#46; Barsotti"
                            2 => "V&#46; Iacopetti"
                            3 => "G&#46; Iacopetti"
                            4 => "P&#46; Pepe"
                            5 => "A&#46; d&#8217;Ascanio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00296-013-2910-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "2014"
                        "volumen" => "34"
                        "paginaInicial" => "565"
                        "paginaFinal" => "569"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24322453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of a novel autoantibody directed against small ubiquitin-like modifier activating enzyme in dermatomyositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Z&#46; Betteridge"
                            1 => "H&#46; Gunawardena"
                            2 => "J&#46; North"
                            3 => "J&#46; Slinn"
                            4 => "N&#46; McHugh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.22862"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "3132"
                        "paginaFinal" => "3137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17763420"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High incidence of cancer in anti-small ubiquitin-like modifier activating enzyme antibody-positive dermatomyositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Muro"
                            1 => "K&#46; Sugiura"
                            2 => "M&#46; Nara"
                            3 => "I&#46; Sakamoto"
                            4 => "N&#46; Suzuki"
                            5 => "M&#46; Akiyama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/kev247"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology &#40;Oxford&#41;"
                        "fecha" => "2015"
                        "volumen" => "54"
                        "paginaInicial" => "1745"
                        "paginaFinal" => "1747"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26163288"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A North American cohort of anti-SAE dermatomyositis&#58; clinical phenotype&#44; testing&#44; and review of cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Albayda"
                            1 => "C&#46; Mecoli"
                            2 => "L&#46; Casciola-Rosen"
                            3 => "S&#46;K&#46; Danoff"
                            4 => "C&#46;T&#46; Lin"
                            5 => "D&#46; Hines"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/acr2.11247"
                      "Revista" => array:6 [
                        "tituloSerie" => "ACR Open Rheumatol"
                        "fecha" => "2021"
                        "volumen" => "3"
                        "paginaInicial" => "287"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33774928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Four dermatomyositis-specific autoantibodies-anti-TIF1&#947;&#44; anti-NXP2&#44; anti-SAE and anti-MDA5-in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46; Bodoki"
                            1 => "M&#46; Nagy-Vincze"
                            2 => "Z&#46; Griger"
                            3 => "Z&#46; Betteridge"
                            4 => "L&#46; Sz&#246;ll&#337;si"
                            5 => "K&#46; Dank&#243;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.autrev.2014.08.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Autoimmun Rev"
                        "fecha" => "2014"
                        "volumen" => "13"
                        "paginaInicial" => "1211"
                        "paginaFinal" => "1219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25182203"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0415"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Zampeli"
                            1 => "A&#46; Venetsanopoulou"
                            2 => "O&#46;D&#46; Argyropoulou"
                            3 => "C&#46;P&#46; Mavragani"
                            4 => "M&#46;G&#46; Tektonidou"
                            5 => "P&#46;G&#46; Vlachoyiannopoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10067-018-4267-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Rheumatol"
                        "fecha" => "2019"
                        "volumen" => "38"
                        "paginaInicial" => "125"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30145635"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0420"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The spectrum and clinical significance of myositis-specific autoantibodies in Chinese patients with idiopathic inflammatory myopathies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Li"
                            1 => "Y&#46; Ge"
                            2 => "H&#46; Yang"
                            3 => "T&#46; Wang"
                            4 => "X&#46; Zheng"
                            5 => "Q&#46; Peng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10067-019-04503-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Rheumatol"
                        "fecha" => "2019"
                        "volumen" => "38"
                        "paginaInicial" => "2171"
                        "paginaFinal" => "2179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30863950"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0425"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical and human leucocyte antigen class II haplotype associations of autoantibodies to small ubiquitin-like modifier enzyme&#44; a dermatomyositis-specific autoantigen target&#44; in UK Caucasian adult-onset myositis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46;E&#46; Betteridge"
                            1 => "H&#46; Gunawardena"
                            2 => "H&#46; Chinoy"
                            3 => "J&#46; North"
                            4 => "W&#46;E&#46; Ollier"
                            5 => "R&#46;G&#46; Cooper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2009"
                        "volumen" => "68"
                        "paginaInicial" => "1621"
                        "paginaFinal" => "1625"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0430"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autoantibodies to small ubiquitin-like modifier activating enzymes in Japanese patients with dermatomyositis&#58; comparison with a UK Caucasian cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Fujimoto"
                            1 => "T&#46; Matsushita"
                            2 => "Y&#46; Hamaguchi"
                            3 => "K&#46; Kaji"
                            4 => "Y&#46; Asano"
                            5 => "F&#46; Ogawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2012-201736"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2013"
                        "volumen" => "72"
                        "paginaInicial" => "151"
                        "paginaFinal" => "153"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22843487"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack645213"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0120" class="elsevierStylePara elsevierViewall">The authors would like to acknowledge the colleagues in the departments for their help in the preparation of this work&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23870206/0000016000000001/v1_202301060844/S2387020622005824/v1_202301060844/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "43310"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016000000001/v1_202301060844/S2387020622005824/v1_202301060844/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020622005824?idApp=UINPBA00004N"
]