IgG4-related sclerosing cholangitis may be a risk factor for cancer
IgG4-related sclerosing cholangitis may be a risk factor for cancer
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DOI：
10.1002/jhbp.957
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发表时间：
2021-05-24
影响因子：
3
通讯作者：
Kubota, Kensuke
中科院分区：
文献类型：
--
作者：
Kurita, Yusuke;Fujita, Yuji;Kubota, Kensuke
背景与目的：自身免疫性胰腺炎（AIP）与恶性肿瘤的关系已有报道。然而，免疫球蛋白4（IgG 4）相关的硬化性胆管炎（IgG 4-SC）患者的潜在癌症风险尚不清楚。方法回顾性分析7家医院121例IgG 4-SC患者的临床资料，分析IgG 4-SC与肿瘤的关系。我们根据全国癌症发病率计算了IgG 4-SC患者的癌症标准化发病率（SIR）。结果121例IgG 4-SC患者平均随访6.4年，平均随访时间1.5年。在随访期间，26名患者患有癌症，29名癌症被诊断出来。IgG 4-SC诊断后癌症的SIR为1.90（95%置信区间[CI] 1.67-2.21）。胰腺癌和胆管癌的SIR分别为10.30和8.88。IgG 4-SC阳性者5年内患癌的SIR分别为2.58、1.01和2.44。结论IgG 4-SC阳性者患癌的危险性较高，包括胰腺癌和胆管癌。IgG 4-SC患者在确诊后5年内患癌的风险较高，因此，IgG 4-SC患者可能需要仔细的长期随访。
Background/Purpose The relationship between autoimmune pancreatitis (AIP) and malignancy has been reported. However, the potential risk for cancer in patients with immunoglobulin 4 (IgG4)-related sclerosing cholangitis (IgG4-SC) is unclear. The present study aimed to evaluate the incidence of cancer in IgG4-SC patients.Methods We retrospectively collected clinical data for 121 patients diagnosed with IgG4-SC from 7 hospitals. We calculated the standardized incidence ratio (SIR) of cancer in IgG4-SC patients based on the national cancer rates. The SIR of the period after the diagnosis of IgG4-SC were calculated.Results The mean follow-up period was 6.4 years, with 121 IgG4-SC patients. During the follow-up period, 26 patients had cancer, and 29 cancers were diagnosed. The SIR of cancer after the diagnosis of IgG4-SC was 1.90 (95% confidence interval [CI] 1.67-2.21). The SIR of pancreatic and bile duct cancer was 10.30 and 8.88, respectively. The SIR of cancer in 5 years after diagnosis of IgG4-SC were 2.58, 1.01, and 2.44, respectively.Conclusions IgG4-SC patients have a high risk of cancer including pancreatic and bile duct cancer. The risk of cancer was high less 5 years after diagnosis of IgG4-SC. Therefore, IgG4-SC patients may require careful long-term follow-up.