IgG4‐related sclerosing cholangitis may be a risk factor for cancer

• Published in: Journal of hepato-biliary-pancreatic sciences 2021-06, Vol.28 (6), p.524-532
• Main Authors: Kurita, Yusuke, Fujita, Yuji, Sekino, Yusuke, Watanabe, Seitaro, Iwasaki, Akito, Kagawa, Koichi, Tanida, Emiko, Yagi, Shin, Hasegawa, Sho, Sato, Takamitsu, Hosono, Kunihiro, Kato, Shingo, Kobayashi, Noritoshi, Ichikawa, Yasushi, Endo, Itaru, Nakajima, Atsushi, Kubota, Kensuke
• Format: Article
• Language: English
• Subjects: Bile; bile duct cancer; Cancer; Cholangiocarcinoma; Cholangitis; IgG4‐related sclerosing cholangitis; inflammation; malignancy; Pancreatic cancer
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1002/jhbp.957

Background/Purpose The relationship between autoimmune pancreatitis (AIP) and malignancy has been reported. However, the potential risk for cancer in patients with immunoglobulin 4 (IgG4)‐related sclerosing cholangitis (IgG4‐SC) is unclear. The present study aimed to evaluate the incidence of cancer in IgG4‐SC patients. Methods We retrospectively collected clinical data for 121 patients diagnosed with IgG4‐SC from 7 hospitals. We calculated the standardized incidence ratio (SIR) of cancer in IgG4‐SC patients based on the national cancer rates. The SIR of the period after the diagnosis of IgG4‐SC were calculated. Results The mean follow‐up period was 6.4 years, with 121 IgG4‐SC patients. During the follow‐up period, 26 patients had cancer, and 29 cancers were diagnosed. The SIR of cancer after the diagnosis of IgG4‐SC was 1.90 (95% confidence interval [CI] 1.67‐2.21). The SIR of pancreatic and bile duct cancer was 10.30 and 8.88, respectively. The SIR of cancer in 5 years after diagnosis of IgG4‐SC were 2.58, 1.01, and 2.44, respectively. Conclusions IgG4‐SC patients have a high risk of cancer including pancreatic and bile duct cancer. The risk of cancer was high less 5 years after diagnosis of IgG4‐SC. Therefore, IgG4‐SC patients may require careful long‐term follow‐up. Highlight In this retrospective study, Kurita and colleagues found that the risk of cancer, including pancreatic and bile duct cancer, is high in patients with IgG4‐related sclerosing cholangitis. The risk was high 5 years after diagnosis, suggesting that patients with IgG4‐related sclerosing cholangitis may require careful long‐term follow‐up.