Serum IgG4 Elevation in Pancreatic Cancer Diagnostic and Prognostic Significance and Association With Autoimmune Pancreatitis
Serum IgG4 Elevation in Pancreatic Cancer Diagnostic and Prognostic Significance and Association With Autoimmune Pancreatitis
复制标题
DOI：
10.1097/mpa.0000000000000297
复制
发表时间：
2015-05-01
期刊：
影响因子：
2.9
通讯作者：
Chari, Suresh T.
中科院分区：
文献类型：
--
作者：
Ngwa, Taiwo;Law, Ryan;Chari, Suresh T.
目的：胰腺癌（PaC）患者血清IgG_4（sIgG_4）升高，是自身免疫性胰腺炎（AIP）的常见表现。我们研究了sIgG 4是否可以区分AIP和PaC.Methods的，其作用在prestication，AIP和PaC.Methods的伴随发生：我们确定了所有患者PaC（n = 548）和1型AIP（n = 99）与sIgG 4测量从2001年至2011年。我们比较了这些群体的人口统计学特征和sIgG 4谱。在PaC患者中，我们比较了sIgG 4升高和不升高的可切除性和死亡率。结果：AIP患者sIgG 4升高（65% vs10.4%，P < 0.001）和sIgG 4超过正常上限2倍（40% vs2.4%，P < 0.001）的可能性更大。与sIgG 4正常的患者相比，sIgG 4升高的PaC患者更常见于男性（81% vs 53%）。两组年龄相似，切除率和死亡率相似。结论：sIgG 4轻度升高不能区分AIP与PaC。AIP中升高超过正常值上限2倍的情况更为常见。血清IgG 4升高对PaC无预后意义。我们无法确定AIP和PaC之间的关系。
Objective: Serum IgG4 (sIgG4) elevation, more common to autoimmune pancreatitis (AIP), occurs in some patients with pancreatic cancer (PaC). We investigated whether sIgG4 could differentiate AIP from PaC, its role in prognostication, and the concomitant occurrence of AIP and PaC.Methods: We identified all patients with PaC (n = 548) and with type 1 AIP (n = 99) with sIgG4 measurements from 2001 to 2011. We compared demographics and sIgG4 profiles in these groups. Among patients with PaC, we compared resectability and mortality with and without elevated sIgG4. We reviewed AIP and PaC tissue specimens to identify concomitant occurrence of both diseases.Results: Patients with AIP were more likely to have elevation in sIgG4 (65% vs 10.4%, P < 0.001) and sIgG4 more than 2 times upper limit of normal (40% vs 2.4%, P < 0.001). Patients with PaC with sIgG4 elevation were more commonly male compared with those with normal sIgG4 (81% vs 53%). Both groups were similarly aged with similar rates of resectability and mortality. No evidence of concurrent PaC and AIP was found.Conclusions: Mild elevations in sIgG4 cannot distinguish AIP from PaC. Elevations more than 2 times upper limit of normal appear more commonly in AIP. Serum IgG4 elevation has no prognostic significance in PaC. We could not identify a relationship between AIP and PaC.