报道称，在肿瘤微环境中，IgG4阳性浆细胞增加，并且许多癌症中肿瘤中的这些细胞数量较高是一个不良的预后因素。然而，在肝内胆管癌（ICC）中没有报道IgG4表达的分析。本研究旨在分析ICC患者的与预后相关的临床病理特征与IgG4表达之间的关系。我们鉴定了2010年1月至2020年12月间接受手术切除的37名ICC患者。通过免疫染色法分析了肿瘤、侵入前缘和肿瘤附近基质中IgG阳性和IgG4阳性浆细胞的数量。此外，我们研究了预后相关临床病理数据与ICC患者IgG4阳性浆细胞数量和IgG4/IgG比率之间的关系。 肿瘤内区域、侵入前缘和靠近肿瘤的非癌组织区域（NCA）中IgG4阳性浆细胞的百分比分别为91.9％、56.8％和81.1％。对于除一例NCA组织外的所有病例，每个区域都观察到IgG阳性浆细胞。侵入前缘中高IgG4表达水平和IgG4/IgG比率与不良总生存率（OS）显着相关（Logrank检验p=0.0438和p=0.0338，分别）。OS的多元分析表明，高IgG4表达（p=0.0140）、淋巴结转移（p=0.0205）和手术切缘阳性（p=0.0009）或高IgG4/IgG比率（p=0.0051）、淋巴结转移（p=0.0280）和手术切缘阳性（p=0.0009）是独立的不良预后因素。总之，侵入前缘中高IgG4表达水平和IgG4/IgG比率是ICC的独立不良预后因素。针对IgG4的靶向治疗可能改善ICC患者的预后。版权所有©2023年澳大利亚病理学皇家学院。由Elsevier B.V.出版。保留所有权利。

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.Copyright © 2023 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.