Summary
IgG4-positive plasma cells are reportedly increased in the tumour microenvironment,
and a high number of these cells in tumours is a poor prognostic factor in several
cancers. However, there are no reported analyses of IgG4 expression in intrahepatic
cholangiocarcinoma (ICC). This study aimed to analyse the correlations between prognosis-related
clinicopathological features of patients with ICC and IgG4 expression. We identified
37 ICC patients who underwent surgical resection between January 2010 and December
2020. The number of IgG-positive and IgG4-positive plasma cells in the tumour, invasion
front, and stroma near the tumour was analysed by immunostaining. Furthermore, we
examined the association of prognosis-related clinicopathological data with the number
of IgG4-positive plasma cells and IgG4/IgG ratio in ICC patients. The IgG4-positive
plasma cell percentages for the intra-tumour area, invasion front, and non-cancerous
area (NCA) near the tumour were 91.9%, 56.8%, and 81.1%, respectively. IgG-positive
plasma cells were observed in each region for all cases, except for NCA tissue in
one case. A high IgG4 expression level and IgG4/IgG ratio in the invasion front were
significantly associated with poor overall survival (OS) (log-rank test p=0.0438 and p=0.0338, respectively). Multivariate analysis for OS revealed that high IgG4 expression
(p=0.0140), lymph node metastasis (p=0.0205), and positive surgical margin (p=0.0009) or a high IgG4/IgG ratio (p=0.0051), lymph node metastasis (p=0.0280), and positive surgical margin (p=0.0009) were independent poor prognostic factors. In conclusion, a high IgG4 expression
level and IgG4/IgG ratio in the invasion front are independent poor prognostic factors
for ICC. Targeted therapy for IgG4 may improve the prognosis for patients with ICC.
Key words
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Article info
Publication history
Published online: February 24, 2023
Accepted:
November 8,
2022
Received in revised form:
September 14,
2022
Received:
June 29,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.
