ArticleDigestive diseases and sciences2014
Serum level of Ca 19-9 increases ability of IgG4 test to distinguish patients with autoimmune pancreatitis from those with pancreatic carcinoma.
Article in Digestive diseases and sciences, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis.BMC gastroenterology · 2024Pooled it
- European Guideline on IgG4-related digestive disease - UEG and SGF evidence-based recommendations.United European gastroenterology journal · 2020Guideline
- Diagnostic performance of serum IgG4 level for IgG4-related disease: a meta-analysis.Scientific reports · 2016Pooled it
- Reconsidering pancreatic masses: A case of IgG4-related autoimmune pancreatitis mimicking malignancy.Radiology case reports · 2026Article
- Elevated CA19-9 in IgG4-Related Autoimmune Pancreatitis: A Single-Center Retrospective Cohort Study.International journal of general medicine · 2026Article
- Focal Autoimmune Pancreatitis Morphologically Mimicking Pancreatic Cancer: A Case Report and Literature Review.The American journal of case reports · 2024Review
- Autoimmune pancreatitis: Cornerstones and future perspectives.World journal of gastroenterology · 2024Review
- Focal Type 2 Autoimmune Pancreatitis Mimicking Pancreatic Cancer: Treatment with Neoadjuvant Chemotherapy and Surgery.Internal medicine (Tokyo, Japan) · 2023Article
- Serum biomarkers for the differentiation of autoimmune pancreatitis from pancreatic ductal adenocarcinoma.World journal of gastrointestinal oncology · 2023Review
- Is Surgery in Autoimmune Pancreatitis Always a Failure?Medicina (Kaunas, Lithuania) · 2023Review
- Challenges for clinicians treating autoimmune pancreatitis: Current perspectives.World journal of clinical cases · 2023Review
- Mass-forming immunoglobulin G4-related cholangitis with atypical pancreatic lesions: a case report of difficult diagnosis.American journal of translational research · 2023Article
- The Clinical Utility of Soluble Serum Biomarkers in Autoimmune Pancreatitis: A Systematic Review.Biomedicines · 2022Review
- Article
- Circulating IgG4Gastro hep advances · 2022Article
- Approach to management of pancreatic strictures: the gastroenterologist's perspective.Clinical journal of gastroenterology · 2021Review
- Imaging of inflammatory disease of the pancreas.The British journal of radiology · 2021Review
- Challenging biliary strictures: pathophysiological features, differential diagnosis, diagnostic algorithms, and new clinically relevant biomarkers - part 1.Therapeutic advances in gastroenterology · 2020Review
- Article
- From Pathogenesis, Clinical Manifestation, and Diagnosis to Treatment: An Overview on Autoimmune Pancreatitis.Gastroenterology research and practice · 2017Review
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAutoimmune pancreatitis (AIP) is often difficult to distinguish from pancreatic carcinoma or other pancreatobiliary diseases. High serum levels of carbohydrate antigen 19-9 (Ca 19-9) are indicative of malignancies, whereas high levels of immunoglobulin (Ig)G4 (>1.4 g/l) are characteristic of AIP. We investigated whether serum levels of these proteins can differentiate between these diseases.
methodsWe measured levels of Ca 19-9 and IgG4 in serum samples from 33 patients with AIP, 53 with pancreatic carcinoma, and 145 with other pancreatobiliary disorders. We determined cut-off levels for each assay. Logistic regression analysis was used to evaluate combined data on Ca 19-9, IgG4, and bilirubin levels.
resultsLow levels of Ca 19-9 were independently associated with AIP, compared with pancreatic adenocarcinoma [odds ratio (OR) 0.28; 95% confidence interval (CI) 0.13-0.59; p = 0.0001]. Using an upper level of 74 U/ml, the assay for Ca 19-9 identified patients with AIP with 73% sensitivity and 74% specificity. Using a lower level of 2.6 g/l, the assay for IgG4 identified these patients with 70% sensitivity and 100% specificity. Combining data, levels of Ca 19-9 < 74 U/ml and IgG4 > 1.0 g/l identified patients with AIP with 94% sensitivity and 100 % specificity.
conclusionsPatients with AIP have lower levels of Ca 19-9 than those patients with pancreatic carcinoma. Measurement of either the Ca 19-9 or the IgG4 level alone are not accurate enough for diagnosis. However, the combination of Ca 19-9 < 74 U/ml and IgG4 > 1.0 g/l distinguishes patients with AIP from those patients with pancreatic carcinoma with 94% sensitivity and 100% specificity.
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