Abstract
The only generally accepted serological marker currently used for the diagnosis of autoimmune pancreatitis (AIP) is IgG4. Our aim was mainly to determine whether hybrid κ\\λ antibody can help to diagnose AIP and to differentiate it from pancreatic cancer. We established an enzyme-linked immunosorbent assay (ELISA) system to measure the levels of hybrid κ\\λ antibodies in human sera. Sera were obtained from 338 patients, including 61 with AIP, 74 with pancreatic cancer, 50 with acute pancreatitis, 40 with ordinary chronic pancreatitis, 15 with miscellaneous pancreatic diseases, and 98 with normal pancreas. Our study showed levels of hybrid κ\\λ antibodies in the AIP group were significantly higher than in the non-AIP group (P < 0.001). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of AIP were 80.3%, 91%, 66.2% and 95.5% respectively. Furthermore, the combined measurement of serum hybrid κ\\λ antibody and IgG4 tended to increase the sensitivity although the difference was not statistically significant (90.2% vs. 78.7%, P = 0.08), compared to measurement of IgG4 alone. Our findings suggest that hybrid κ\\λ antibody could be a new serological marker to diagnose AIP and differentiate it from pancreatic cancer.
Highlights
CA19-9 is considered as a biomarker in pancreatic cancer, but this can be elevated in other pancreatic diseases such as chronic pancreatitis, or in other pathological states[19]
Because autoimmune pancreatitis (AIP) is characterized by an elevated serum IgG4 concentration, we attempted to investigate the diagnostic utility of hybrid κ/λantibody in the diagnosis of AIP and its differentiation from pancreatic cancer
Because the principal differential diagnosis of AIP is pancreatic cancer, we aimed to evaluate the use of serum hybrid κ\λantibody and combined measurement with serum IgG4 in differentiating between the two diseases
Summary
One report showed that hybrid κ/λantibodies compose a substantial portion of IgG4 in normal human serum[25]. These molecules are formed by two IgG4 heavy chains plus one κand one λlight chain. Because AIP is characterized by an elevated serum IgG4 concentration, we attempted to investigate the diagnostic utility of hybrid κ/λantibody in the diagnosis of AIP and its differentiation from pancreatic cancer. Because the principal differential diagnosis of AIP is pancreatic cancer, we aimed to evaluate the use of serum hybrid κ\λantibody and combined measurement with serum IgG4 in differentiating between the two diseases
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