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논문 기본 정보

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학술저널
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거트앤리버 발행위원회 Gut and Liver Gut and Liver 제7권 제2호
발행연도
2013.1
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234 - 238 (5page)

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Background/Aims: Few studies have differentiated immunoglobulin G (IgG) 4-related sclerosing cholangitis (IgG4-SC) from hilar cholangiocarcinoma (CC). Thus, we sought to investigate useful features for differentiating IgG4-SC from hilar CC. Methods: We retrospectively compared clinical,serological, imaging, and histological features of six patients with IgG4-SC and 42 patients with hilar CC. Results: In patients with hilar CC, obstructive jaundice was more frequent (p<0.01), serum total bilirubin levels were significantly higher (p<0.05), serum CA19-9 levels were significantly higher (p<0.01), and serum duke pancreatic monoclonal antigen type 2 levels were frequently elevated (p<0.05). However,in patients with IgG4-SC, the serum IgG (p<0.05) and IgG4(p<0.01) levels were significantly higher and frequently elevated. The pancreas was enlarged in all IgG4-SC patients but only in 17% of hilar CC patients (p<0.01). Salivary and/or lacrimal gland swelling was detected in only 50% of IgG4-SC patients (p<0.01). Endoscopic retrograde cholangiography revealed that the hilar or hepatic duct was completely obstructed in 83% of hilar CC patients (p<0.01). Lower bile duct stenosis, apart from hilar bile duct stenosis, was more frequent in IgG4-SC patients (p<0.01). Bile duct wall thickening in areas without stenosis was more frequent in IgG4-SC patients (p<0.01). Conclusions: An integrated diagnostic approach based on clinical, serological, imaging, and histological findings is necessary to differentiate IgG4-SC from hilar CC.
#Immunoglobulin G #IgG4-ralated sclerosing cholangitis #Hilar cholangiocarcinoma #Endoscopic retrograde cholangiopancreatography

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참고문헌 (1)

참고문헌 신청
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