IgG4相关性疾病合并恶性肿瘤的病例对照研究

A retrospective case-control study of immunoglobulin G4-related disease combined with malignancy

加深对IgG4相关性疾病（IgG4-RD）合并恶性肿瘤高危人群的认识,提高早期诊断率.回顾分析我院确诊的9例IgG4-RD合并恶性肿瘤患者（恶性肿瘤组）,并根据性别和年龄匹配27例未合并恶性肿瘤IgG4-RD患者（对照组）,进行对照分析.IgG4-RD患者合并恶性肿瘤的发生率为3.3％,高于同年龄组一般人群.恶性肿瘤组9例患者均吸烟,比例明显高于对照组（9/9比16/27,P＜0.05）,两组之间受累器官数目、饮酒史、血清IgG4水平、糖皮质激素治疗情况和原发病复发率的差异均无统计学意义.恶性肿瘤组中,诊断IgG4-RD后1年内发现恶性肿瘤者占6/9;肿瘤按发生率高低依次为结直肠癌、胆系肿瘤和甲状腺癌.吸烟史是IgG4-RD合并恶性肿瘤的高危因素.在诊断IgG4-RD后,应保持警惕并注意筛查和随访,及时发现恶性肿瘤.

IgG4-related disease （IgG4-RD） has been proved to be associated with malignancy.The incidence and risk factors of malignancy development in IgG4-RD were not clear.Nine IgG4-RD patients with malignancies and 27 IgG4-RD control cases were analyzed for risk factors and clinical features.The incidence of malignancy in IgG4-RD was 3.3%,higher than age-controlled general population.Smoking history was significantly more common in patients with malignancies than in the control group （9/9 vs 16/27,P 〈 0.05）.A total of 6/9 malignancies occurred within the first year after the diagnosis of IgG4-RD.Colorectal,biliary and thyroid cancers were the leading types.Smoking history is a risk factor for IgG4-RD associated malignancy.Careful vigilance to monitor malignancy needs to be paid during follow-up.