摘要
目的分析血清免疫球蛋白G4(immunoglobulin G fraction 4,IgG4)升高的胰腺癌(pancreatic cancer)的切除率和生存时间,并讨论血清IgG4对自身免疫性胰腺炎(typeⅠautoimmune pancreatitis,AIP)和胰腺癌的鉴别能力。方法采用回顾性队列研究方法回顾性分析青岛大学附属医院2016年1月至2019年12月期间收治的146例病理组织学检查证实为胰腺癌患者的临床资料,并根据血清IgG4水平分为IgG4正常组(<1.35 g/L,n=124)和IgG4升高组(≥1.35 g/L,n=22)。比较2组患者的肿瘤切除率、生存时间及是否同时合并有AIP。结果血清IgG4正常组行根治性手术101例(81.5%),而血清IgG4升高组仅13例(59.1%)接受了根治性手术,其差异有统计学意义(P=0.019);2组患者的生存时间比较,血清IgG4正常组中位生存时间为18.7个月,而血清IgG4升高组为8.1个月,差异无统计学意义(P=0.121);进一步分析2组中胰腺导管腺癌患者的生存时间,结果显示血清IgG4正常组的中位生存时间为17.5个月,而血清IgG4升高组为6.8个月,差异有统计学意义(P=0.016);2组患者中有1例胰腺癌合并AIP。结论血清IgG4≥1.35 g/L的胰腺癌的根治性切除率低,且血清IgG4≥1.35 g/L的胰腺导管腺癌的预后不良;血清IgG4只能作为鉴别胰腺癌与AIP的辅助指标。
Objective To analyze the R0 resection rate and survival time of pancreatic cancer with serum IgG4 elevated,and to discuss whether serum IgG4 can distinguish autoimmune pancreatitis from pancreatic cancer.Methods The retrospective cohort study was adopted.The clinical data of 146 patients with pancreatic cancer confirmed by histology in Affiliated Hospital of Qingdao University from January 2016 to December 2019 were analyzed retrospectively.According to the level of serum IgG4,they were divided into normal IgG4 group(<1.35 g/L,n=124)and IgG4 elevated group(≥1.35 g/L,n=22).The tumor R0 resection rate,survival time and whether complicated with AIP of the two groups were compared.Results One hundred and one patients(81.5%)with normal serum IgG4 underwent radical surgery,while only 13 patients(59.1%)with elevated serum IgG4 underwent radical surgery,the difference was significant(P=0.019).The median survival time of patients with normal serum IgG4 was 18.7 months,while patients with elevated serum IgG4 was8.1 months,there was no significant difference between the two groups(P=0.121).Subgroup analysis showed that the median survival time of patients with pancreatic ductal adenocarcinoma in the normal IgG4 group was 17.5 months,while the IgG4 elevated group was 6.8 months,the difference was significant(P=0.016).Only 1 case of pancreatic cancer with AIP in the 2 groups.Conclusions Serum IgG4≥1.35 g/L indicates low radical resection rate in pancreatic cancer and poor prognosis in pancreatic ductal adenocarcinoma.Serum IgG4 can only be used as an auxiliary index to distinguish pancreatic cancer from autoimmune pancreatitis.
作者
裴金宇
刘鹏
曹广华
王晶
马湘
曲林林
PEI Jinyu;LIU Peng;CAO Guanghua;WANG Jing;MA Xiang;QU Linlin(Department of Hepatobiliary Pancreatic Surgery,The Affiliated Hospital of Qingdao University,Qingdao,Shandong 266003,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2021年第6期774-778,共5页
Chinese Journal of Bases and Clinics In General Surgery
