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Autoimmune pancreatitis linked to higher risk for various cancers
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Patients with autoimmune pancreatitis are at increased risk for developing various cancers, particularly within the first year of diagnosis, according to recent results.
In a multicenter, retrospective cohort study in Japan, researchers evaluated 108 patients with autoimmune pancreatitis (AIP). The rates of and time to cancer development within the cohort were established, and clinicopathological characteristics were compared between participants with and without cancer.
Eighteen cancers developed in 15 participants during a median follow-up of 3.3 years; 10 were detected within the first year of AIP diagnosis. Seven cases of stomach cancer were observed, three of lung cancer, two each of non-Hodgkin’s lymphoma, prostate and colon cancers, and one each of bile duct and thyroid cancers.
Investigators calculated a standardized incidence ratio (SIR) for cancer of 2.7 (1.4-3.9), along with a relative risk of 4.9 (1.7-14.9) at diagnosis compared with controls. When stratified for time from AIP diagnosis, SIR for cancer development was 6.1 (2.3-9.9) for the first year and 1.5 (0.3-2.8) for subsequent years (95% CI for all).
Patients with cancer had greater serum levels of IgG4 at AIP diagnosis than those without (738 mg/dL vs. 389 mg/dL; P=.02). Among eight patients with cancer assessed before treatment with corticosteroids, six indicated IgG4-positive plasma cell infiltration in the tissue surrounding their tumors. All successfully underwent treatment and corticosteroid therapy, and none of the six participants experienced AIP relapse during a median follow-up of 4.7 years. Overall, AIP relapse occurred at a rate of 0.20 among cancer patients and 0.046 among those without.
“Patients who fulfilled the accepted criteria for AIP are at high risk for having cancer,” the researchers concluded. “The highest risk for cancer is in the first year after AIP diagnosis, including the time at the diagnosis of AIP, and there is a very low relapse rate of AIP after successful treatment. More studies are needed to determine whether screening for neoplasia should be done in patients with AIP, and also to decide whether high prevalence of cancer in our cohort really reflects its paraneoplastic phenomenon.”
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