Junpei Asano1, Takayuki Watanabe1, Takaya Oguchi1, Keita Kanai1, Masahiro Maruyama1, Tetsuya Ito1, Takashi Muraki1, Hideaki Hamano1, Norikazu Arakura1, Akihiro Matsumoto1, Shigeyuki Kawa2. 1. From the Department of Gastroenterology, the Endoscopic Examination Center, and the Center for Health, Safety, and Environmental Management, Shinshu University School of Medicine, Matsumoto, Japan.J. Asano, MD, Department of Gastroenterology, Shinshu University School of Medicine; T. Watanabe, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Oguchi, MD, Department of Gastroenterology, Shinshu University School of Medicine; K. Kanai, MD, Department of Gastroenterology, Shinshu University School of Medicine; M. Maruyama, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Ito, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Muraki, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; H. Hamano, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; N. Arakura, MD, PhD, Endoscopic Examination Center, Shinshu University School of Medicine; A. Matsumoto, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; S. Kawa, MD, PhD, Center for Health, Safety, and Environmental Management, Shinshu University. 2. From the Department of Gastroenterology, the Endoscopic Examination Center, and the Center for Health, Safety, and Environmental Management, Shinshu University School of Medicine, Matsumoto, Japan.J. Asano, MD, Department of Gastroenterology, Shinshu University School of Medicine; T. Watanabe, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Oguchi, MD, Department of Gastroenterology, Shinshu University School of Medicine; K. Kanai, MD, Department of Gastroenterology, Shinshu University School of Medicine; M. Maruyama, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Ito, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; T. Muraki, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; H. Hamano, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; N. Arakura, MD, PhD, Endoscopic Examination Center, Shinshu University School of Medicine; A. Matsumoto, MD, PhD, Department of Gastroenterology, Shinshu University School of Medicine; S. Kawa, MD, PhD, Center for Health, Safety, and Environmental Management, Shinshu University. skawapc@shinshu-u.ac.jp.
Abstract
OBJECTIVE: Because it is uncertain whether immunoglobulin G4-related disease (IgG4-RD) is associated with malignancy, we evaluated the incidence of cancer development in a large cohort of patients with IgG4-RD. METHODS: The study enrolled 158 patients diagnosed as having IgG4-RD between 1992 and 2012. We calculated the standardized incidence ratio (SIR) and cumulative rate of malignancies in this group and searched for risk factors associated with the occurrence of tumors. RESULTS: A total of 34 malignancies were observed in the patients with IgG4-RD over a mean followup period of 5.95 ± 4.48 years. The overall SIR of malignancies was 2.01 (95% CI 1.34-2.69). The SIR of patients who exhibited a tumor within 1 year after IgG4-RD diagnosis was 3.53 (95% CI 1.23-5.83), while that of subjects forming a malignancy in subsequent years was 1.48 (95% CI 0.99-1.98). The cumulative rate of malignancy development was significantly higher in patients with IgG4-RD within 12 years after diagnosis than in the Japanese general population. Comparable results were obtained for an autoimmune pancreatitis subgroup. The serum concentrations of several disease activity markers at diagnosis were significantly higher in patients with malignancies than in those without. CONCLUSION: We identified a close association between IgG4-RD and malignancy formation within 12 years after diagnosis, particularly during the first year. An active IgG4-RD state is presumed to be a strong risk factor for malignancy development.
OBJECTIVE: Because it is uncertain whether immunoglobulin G4-related disease (IgG4-RD) is associated with malignancy, we evaluated the incidence of cancer development in a large cohort of patients with IgG4-RD. METHODS: The study enrolled 158 patients diagnosed as having IgG4-RD between 1992 and 2012. We calculated the standardized incidence ratio (SIR) and cumulative rate of malignancies in this group and searched for risk factors associated with the occurrence of tumors. RESULTS: A total of 34 malignancies were observed in the patients with IgG4-RD over a mean followup period of 5.95 ± 4.48 years. The overall SIR of malignancies was 2.01 (95% CI 1.34-2.69). The SIR of patients who exhibited a tumor within 1 year after IgG4-RD diagnosis was 3.53 (95% CI 1.23-5.83), while that of subjects forming a malignancy in subsequent years was 1.48 (95% CI 0.99-1.98). The cumulative rate of malignancy development was significantly higher in patients with IgG4-RD within 12 years after diagnosis than in the Japanese general population. Comparable results were obtained for an autoimmune pancreatitis subgroup. The serum concentrations of several disease activity markers at diagnosis were significantly higher in patients with malignancies than in those without. CONCLUSION: We identified a close association between IgG4-RD and malignancy formation within 12 years after diagnosis, particularly during the first year. An active IgG4-RD state is presumed to be a strong risk factor for malignancy development.
Authors: J-Matthias Löhr; Ulrich Beuers; Miroslav Vujasinovic; Domenico Alvaro; Jens Brøndum Frøkjær; Frank Buttgereit; Gabriele Capurso; Emma L Culver; Enrique de-Madaria; Emanuel Della-Torre; Sönke Detlefsen; Enrique Dominguez-Muñoz; Piotr Czubkowski; Nils Ewald; Luca Frulloni; Natalya Gubergrits; Deniz Guney Duman; Thilo Hackert; Julio Iglesias-Garcia; Nikolaos Kartalis; Andrea Laghi; Frank Lammert; Fredrik Lindgren; Alexey Okhlobystin; Grzegorz Oracz; Andrea Parniczky; Raffaella Maria Pozzi Mucelli; Vinciane Rebours; Jonas Rosendahl; Nicolas Schleinitz; Alexander Schneider; Eric Fh van Bommel; Caroline Sophie Verbeke; Marie Pierre Vullierme; Heiko Witt Journal: United European Gastroenterol J Date: 2020-06-18 Impact factor: 4.623
Authors: George Goodchild; Rory Jr Peters; Tamsin N Cargill; Harry Martin; Adetokunbo Fadipe; Maria Leandro; Adam Bailey; Jane Collier; Louisa Firmin; Manil Chouhan; Manuel Rodriguez-Justo; Ross Sadler; Roger W Chapman; Helen Bungay; Eve Fryer; Joel David; Raashid Luqmani; Eleanor Barnes; George J Webster; Emma L Culver Journal: Clin Med (Lond) Date: 2020-05 Impact factor: 2.659