IgG4 reaction in cholangiocarcinoma and pancreatic carcinoma reflects an evasion from host immunosurveilance by carcinoma

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The relation between cholangiocarcinoma and its precursor lesion (BilIN) and IgG4-related tissue reaction with respect to carcinogenesis was examined. About 30% of cholangiocarcinoma and BilIN showed infiltration of considerable number of IgG4+ plasma cells. There is correlation between expression of Fox3 and IgG4 tissue reaction. Clinicopathological study showed that the cholangiocarcinoma patients with IgG4 tissue reaction showed poor biological behaviors and poor post-operative survival. Cell culture studies showed that cultured cholangiocarcinoma cells express Fox3 mRNA and IL10 mRNA, and cancer cells present immunoregulatory roles by expressing these molecules. It seems plausible that cancer cells themselves are involved in IgG4 tissue reaction. In conclusion, some cholangiocarcinoma showed rich IgG4+ plasma cells and IgG4 tissue reaction reflect an evasion from immunosurveillance of host and cancer cells themsevels are involved in IgG4 tissue reaction by playing roles of Tregs.