The significance of serum IgG4 and CA19-9, autoantibodies in diagnosis and differential diagnosis of IgG4-related sclerosing cholangitis

Scand J Gastroenterol. 2018 Feb;53(2):206-211. doi: 10.1080/00365521.2017.1416159. Epub 2017 Dec 22.

Abstract

Objective: To investigate the value of serum levels of IgG4 and CA19-9, and autoantibodies in the diagnosis of IgG4-related sclerosing cholangitis (IgG4-SC).

Methods: We detected the serum IgG4 and CA19-9 of 45 IgG4-SC patients, 173 non-IgG4-SC patients and 48 healthy controls by immunoassay and chemiluminescence, respectively, with antinuclear antibody (ANA), anti-neutrophil antibody (ANCA), anti-smooth muscle antibody (SMA) and anti-mitochondrial antibody (AMA) level detected by indirect immunofluorescence. Then analyze the detection results.

Results: (1) The positive rates of ANA, ANCA, SMA and AMA in patients with IgG4-SC were 40%, 6.67%, 0 and 2.22%. Among them, the positive rate of ANA was significantly higher than that of the healthy control group (p < .01), and the positive rate of ANA, ANCA, SMA and AMA were significantly different from that of the non-IgG4-SC group (p < .05). (2) Serum levels of IgG4 and CA19-9 increased significantly in patients with IgG4-SC compared with the healthy controls (p < .01). The areas under the ROC curve (AUC) of IgG4 and CA19-9 were 0.9750 and 0.6498, respectively (p < .05).

Conclusion: The high levels of serum IgG4 and CA19-9, and autoantibodies detections are of great important clinical value in diagnosis and differential diagnosis of IgG4-SC.

Keywords: CA19-9; IgG4; IgG4-related sclerosing cholangitis; autoantibodies; bile duct cancer; pancreatic cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Tumor-Associated, Carbohydrate / blood*
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Case-Control Studies
  • China
  • Cholangitis, Sclerosing / blood
  • Cholangitis, Sclerosing / diagnosis*
  • Diagnosis, Differential
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Humans
  • Immunoglobulin G / blood*
  • Male
  • Middle Aged

Substances

  • Antigens, Tumor-Associated, Carbohydrate
  • Autoantibodies
  • Biomarkers
  • Immunoglobulin G