Malignancy and IgG4-related disease: the incidence, related factors and prognosis from a prospective cohort study in China

• Published in: Scientific reports Vol. 10; no. 1; p. 4910
• Main Authors: Tang, Hanqi, Yang, Huaxia, Zhang, Panpan, Wu, Di, Zhang, Shangzhu, Zhao, Jiuliang, Peng, Linyi, Chen, Hua, Fei, Yunyun, Zhang, Xuan, Zhao, Yan, Zeng, Xiaofeng, Zhang, Fengchun, Zhang, Wen
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 18.03.2020; Nature Publishing Group
• Subjects: 692/4023/1670/122; 692/4028/67/2324; 692/499; Adult; Aged; China - epidemiology; Cohort analysis; Cohort Studies; Demography; Disease Management; Disease Susceptibility; Eosinophilia; Female; Health risk assessment; Humanities and Social Sciences; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease - diagnosis; Immunoglobulin G4-Related Disease - epidemiology; Immunoglobulin G4-Related Disease - etiology; Incidence; Male; Malignancy; Middle Aged; multidisciplinary; Neoplasms - diagnosis; Neoplasms - epidemiology; Neoplasms - etiology; Pancreatitis; Patients; Population Surveillance; Prognosis; Risk Factors; Science; Science (multidisciplinary); China
• DOI: 10.1038/s41598-020-61585-z
• ISSN: 2045-2322

This prospective cohort study aims to investigate the incidence, related factors and prognosis of IgG4-related disease (IgG4-RD) with malignancies in the Chinese cohort. We prospectively analyzed the IgG4-RD patients recruited in Peking Union Medical College Hospital from January 2011 to August 2018 and identified patients diagnosed with IgG4-RD complicating malignancies. Data regarding demographics, clinical features, treatment and prognosis of IgG4-RD patients complicating malignancies were collected and compared to those of age- and sex-matched controls. Among the 587 Chinese patients with IgG4-RD, 17 malignancies were identified. Ten of them developed malignancy after the diagnosis of IgG4-RD, given a standard incidence ratio (SIR) of 2.78 (95%CI 1.33–5.12). Multivariate logistic analysis indicated that autoimmune pancreatitis (OR = 6.230, 95%CI 1.559–24.907, p = 0.010) was positively associated with malignancy, whereas eosinophilia (OR = 0.094, 95%CI 0.010–0.883, p = 0.039) was negatively related with malignancies. During a median follow-up period of 61.4 ± 26.4 months, all patients with IgG4-RD and malignancies survived. We conclude that an increased incidence of malignancy was found in Chinese IgG4-RD cohort. Autoimmune pancreatitis is a potential risk factor, whereas eosinophilia is a possible protective factor for complicating malignancies.