Immunoglobulin G4(IgG4)-related cholecystitis(IgG4-C)is often difficult to distinguish from gallbladder carcinoma(GBC).This study aimed to determine a practical strategy for differentiating between IgG4-C and GBC to a...Immunoglobulin G4(IgG4)-related cholecystitis(IgG4-C)is often difficult to distinguish from gallbladder carcinoma(GBC).This study aimed to determine a practical strategy for differentiating between IgG4-C and GBC to avoid unnecessary surgical resection.The expression of IgG4 in the gallbladder was detected by immunohistochemistry.The clinicopathological and radiological characteristics of IgG4-C patients and GBC patients were analyzed retrospectively.Immunohistochemistry revealed that IgG4 was upregulated in the plasma cells of IgG4-C tissues.The median serum total bilirubin levels were significantly higher in the patients with IgG4-C than in those with GBC(45.8μmol L^-1 vs.29.9μmol L^-1).The serumγ-GGT levels were higher in IgG4-C patients than in GBC patients,whereas the serum levels of CA125 were significantly higher in GBC patients than in IgG4-C patients.The imaging scans were helpful for differentiating IgG4-C from GBC based on the presence of a layered pattern and Rokitansky-Aschoff sinuses in the gallbladder wall.There were no statistically significant differences in age,presence of abdominal pain,level of emaciation between the two groups.Our study demonstrated that the combination of imaging with serum total bilirubin,γ-GGTand CA125 levels can offer added preoperative diagnostic value and reduce the rate of IgG4-C misdiagnosis.展开更多
基金supported by the Special Research Foundation of the National Nature Science Foundation of China(81301865,81672412,81772597 and 81702904)the Guandong Natural Science Foundation(2016A030313840,2017A030311002 and 2018A030313645)+6 种基金the Guangdong Science and Technology Foundation(2016A020215199 and 2017A020215196)Science and Technology Program of Guangzhou,China(201607010111)Pearl River S&T Nova Program of Guangzhou,China(201610010022)the Fundamental Research Funds for the Central Universities(18ykpy22)Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology([2013]163)the Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes(KLB09001)Guangdong Science and Technology Department(2015B050501004,2017B030314026)。
文摘Immunoglobulin G4(IgG4)-related cholecystitis(IgG4-C)is often difficult to distinguish from gallbladder carcinoma(GBC).This study aimed to determine a practical strategy for differentiating between IgG4-C and GBC to avoid unnecessary surgical resection.The expression of IgG4 in the gallbladder was detected by immunohistochemistry.The clinicopathological and radiological characteristics of IgG4-C patients and GBC patients were analyzed retrospectively.Immunohistochemistry revealed that IgG4 was upregulated in the plasma cells of IgG4-C tissues.The median serum total bilirubin levels were significantly higher in the patients with IgG4-C than in those with GBC(45.8μmol L^-1 vs.29.9μmol L^-1).The serumγ-GGT levels were higher in IgG4-C patients than in GBC patients,whereas the serum levels of CA125 were significantly higher in GBC patients than in IgG4-C patients.The imaging scans were helpful for differentiating IgG4-C from GBC based on the presence of a layered pattern and Rokitansky-Aschoff sinuses in the gallbladder wall.There were no statistically significant differences in age,presence of abdominal pain,level of emaciation between the two groups.Our study demonstrated that the combination of imaging with serum total bilirubin,γ-GGTand CA125 levels can offer added preoperative diagnostic value and reduce the rate of IgG4-C misdiagnosis.
