Diagnostic Value Of Serum IgG4 And Combined With CA199 In Autoimmune Pancreatitis

Objective:To investigate the value of serum IgG4 in the detection of autoimmune pancreatitis in the pancreas-related diseases and to investigate the value of serum IgG4,serum carbohydrate antigen 199(CA199),and their combined detection of autoimmune pancreatitis(AIP)and pancreatic cancer(PC).Hope to improve the understanding of AIP and its differential diagnosis ability with PC.Methods:A total of 14 patients with AIP,28 patients with pancreatic cancer,61 patients with acute pancreatitis and 19 patients with chronic pancreatitis were enrolled in the Department of Gastroenterology,Shanxi Provincial People's Hospital Affiliated to Shanxi Medical University from December 2015 to October 2017.Collect their normal information and serum.Serum IgG4 levels were measured using immunoturbidimetric turbidimetry and serum CA199 values were determined using chemiluminescence.The general data and serological data were compared between groups.Evaluate the diagnostic value of serum IgG4,CA199 and their combination in the diagnosis of autoimmune pancreatitis and their differential diagnostic efficacy on AIP and pancreatic cancer.Result:A total of 122 patients were obtained.There was no statistically significant difference in gender and age distribution between the groups(p>0.05).Serum IgG4 concentrations in the AIP group were significantly higher than those in other pancreatic-related disease groups,with statistically significant differences(p<0.001).There was no statisticaldifference between the other groups.The increase in serum IgG4 showed a sensitivity of78.6% and a specificity of 97.5% for the detection of AIP in selected pancreatic-related diseases.Serum CA199 levels in patients with AIP were lower than those in patients with pancreatic cancer(p<0.05),but there was no statistically significant difference compared with other patients with pancreatic related diseases.To AIP and pancreatic cancer for the analysis of the crowd,the sensitivity and specificity of AIP were 78.6%,96.4%respectively at 1.95 g / L IgG4 level.The sensitivity and specificity of AIP were 92.9%,60.7% respectively at 155.722 U / ml CA199 level.When the IgG4> 1.95 g / L and CA199<155.722 U / ml,the sensitivity and specificity of AIP were 71.4%,96.4%.When the IgG4> 1.95 g / L or CA199 <155.722 U / ml,the sensitivity and specificity of AIP were100%,60.7%.The specificity of serum IgG4 in identifying AIP and pancreatic cancer is higher.Serum CA199 has higher sensitivity in identifying AIP and pancreatic cancer.Sensitivity of serum IgG4 can reach 100% when combined with serum IgG4.When the same threshold value of 1.35g/L was used for the same detection method,the specificity was low,but combined detection of serum CA199 could significantly improve the diagnostic value with a specificity of 92.9%.Conclusions:Increased serum IgG4 has a higher positive predictive value for AIP in pancreatic-related diseases.IgG4 has high efficiency in the identification of AIP and pancreatic cancer,When combined with CA199,it helps to improve ability to distinguish AIP from pancreatic cancer.However,due to the small sample size,a large number of high-quality forward-looking articles are still needed to provide evidences for the use of serological data to diagnose AIP in China.