Nackenhorst Maja Carina, Kapalla Marvin, Weidle Simon, Kirchhoff Felix, Zschäpitz David, Sieber Sabine, Reeps Christian, Eckstein Hans-Henning, Schneider Heike, Thaler Markus, Moog Philipp, Busch Albert, Sachs Nadja
Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria.
Division of Vascular and Endovascular Surgery, Department for Visceral, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus and University Hospital, Technische Universität Dresden, 01307 Dresden, Germany.
J Clin Med. 2023 Jun 13;12(12):4029. doi: 10.3390/jcm12124029.
Abdominal aortic aneurysms (AAA) are the most frequent aortic dilation, with considerable morbidity and mortality. Inflammatory (infl) and IgG4-positive AAAs represent specific subtypes of unclear incidence and clinical significance. Here, histologic and serologic analyses with retrospective clinical data acquisition are investigated via detailed histology, including morphologic (HE, EvG: inflammatory subtype, angiogenesis, and fibrosis) and immunhistochemic analyses (IgG and IgG4). In addition, complement factors C3/C4 and immunoglobulins IgG, IgG2, IgG4 and IgE were measured in serum samples and clinical data uses patients' metrics, as well as through semi-automated morphometric analysis (diameter, volume, angulation and vessel tortuosity). A total of 101 eligible patients showed five (5%) IgG4 positive (all scored 1) and seven (7%) inflammatory AAAs. An increased degree of inflammation was seen in IgG4 positive and inflAAA, respectively. However, serologic analysis revealed no increased levels of IgG or IgG4. The operative procedure time was not different for those cases and the short-term clinical outcomes were equal for the entire AAA cohort. Overall, the incidence of inflammatory and IgG4-positive AAA samples seems very low based on histologic and serum analyses. Both entities must be considered distinct disease phenotypes. Short-term operative outcomes were not different for both sub-cohorts.
腹主动脉瘤（AAA）是最常见的主动脉扩张疾病，具有相当高的发病率和死亡率。炎症性（infl）和IgG4阳性的腹主动脉瘤是发病率和临床意义尚不清楚的特定亚型。在此，通过详细的组织学研究，包括形态学（苏木精-伊红染色、弹性纤维染色：炎症亚型、血管生成和纤维化）和免疫组织化学分析（IgG和IgG4），对具有回顾性临床数据采集的组织学和血清学分析进行了研究。此外，还测定了血清样本中的补体因子C3/C4以及免疫球蛋白IgG、IgG2、IgG4和IgE，并使用患者指标以及通过半自动形态计量分析（直径、体积、角度和血管迂曲度）获取临床数据。共有101例符合条件的患者，其中5例（5%）为IgG4阳性（均评分为1），7例（7%）为炎症性腹主动脉瘤。在IgG4阳性和炎症性腹主动脉瘤中分别观察到炎症程度增加。然而血清学分析显示IgG或IgG4水平没有升高。这些病例的手术时间没有差异，整个腹主动脉瘤队列的短期临床结果相同。总体而言，基于组织学和血清分析，炎症性和IgG4阳性腹主动脉瘤样本的发病率似乎非常低。这两种实体都必须被视为不同的疾病表型。两个亚组的短期手术结果没有差异。
