Serum IgG4 elevation in pancreatic cancer

Taiwo Ngwa, Ryan Law, Phil Hart, Thomas Christopher Smyrk, Suresh T Chari

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)557-560
Number of pages4
JournalPancreas
Volume44
Issue number4
DOIs
StatePublished - May 25 2015

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Pancreatic Neoplasms
Pancreatitis
Immunoglobulin G
Serum
Mortality
Demography

Keywords

  • autoimmune pancreatitis
  • pancreatic cancer
  • serum IgG4

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Serum IgG4 elevation in pancreatic cancer. / Ngwa, Taiwo; Law, Ryan; Hart, Phil; Smyrk, Thomas Christopher; Chari, Suresh T.

In: Pancreas, Vol. 44, No. 4, 25.05.2015, p. 557-560.

Research output: Contribution to journalArticle

Ngwa, T, Law, R, Hart, P, Smyrk, TC & Chari, ST 2015, 'Serum IgG4 elevation in pancreatic cancer', Pancreas, vol. 44, no. 4, pp. 557-560. https://doi.org/10.1097/MPA.0000000000000297
Ngwa, Taiwo ; Law, Ryan ; Hart, Phil ; Smyrk, Thomas Christopher ; Chari, Suresh T. / Serum IgG4 elevation in pancreatic cancer. In: Pancreas. 2015 ; Vol. 44, No. 4. pp. 557-560.
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abstract = "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.",
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