Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Am J Surg Pathol. 2010 Sep;34(9):1241-9. doi: 10.1097/PAS.0b013e3181ec07ee.
Autoimmune pancreatitis (AIP) is a recently recognized disease entity. In some patients, this disease is associated with other inflammatory diseases. In this study, we aimed to elucidate the pathologic characteristics of AIP-associated gastritis (AIP-G). We evaluated and compared the pathologic findings and immunohistochemical expressions of immunoglobulin G (IgG)4 and IgG in gastric biopsy specimens from 13 AIP-G patients with those from patients of 2 control groups. We divided the AIP-G patients who did not receive steroid therapy [AIP-G-ST(-)] into the following 2 groups: without Helicobacter pylori (HP) infection [AIP-G-HP(-)] and with HP infection [AIP-G-HP(+)]. The control groups comprised 19 patients who were diagnosed with chronic active gastritis associated with HP infection and 7 patients with nonsteroidal anti-inflammatory drug-induced gastritis. We classified the findings for the gastric mucosa into those for the upper and the lower lamina propria. The characteristic finding of AIP-G groups was diffusely lymphoplasmacytic infiltration in the lamina propria. The IgG4-positive plasma cell/IgG-positive plasma cell ratios (IgG4/IgG ratios) in both the upper and lower lamina propria in the AIP-G-ST(-) groups were predominantly higher than the corresponding values in the other groups. In the AIP-G-ST(-) groups, the IgG4/IgG ratio in the lower lamina propria was predominantly higher than that in the upper lamina propria, irrespective of the HP status. In conclusion, diffuse lymphoplasmacytic infiltration in the lamina propria and increased IgG4/IgG ratio in the gastric mucosa (notably in the lower lamina propria) may be the characteristic findings of AIP-G.
自身免疫性胰腺炎（AIP）是一种新近被认识的疾病实体。在某些患者中，这种疾病与其他炎症性疾病有关。在本研究中，我们旨在阐明与 AIP 相关的胃炎（AIP-G）的病理特征。我们评估和比较了 13 例 AIP-G 患者和 2 个对照组患者的胃活检标本的病理发现和 IgG4 和 IgG 的免疫组化表达。我们将未接受类固醇治疗的 AIP-G 患者 [AIP-G-ST(-)] 分为以下 2 组：无幽门螺杆菌（HP）感染 [AIP-G-HP(-)] 和有 HP 感染 [AIP-G-HP(+)]。对照组包括 19 例诊断为与 HP 感染相关的慢性活动性胃炎患者和 7 例非甾体抗炎药诱导性胃炎患者。我们将胃黏膜的发现分为上、下固有层。AIP-G 组的特征性发现是固有层弥漫性淋巴浆细胞浸润。AIP-G-ST(-)组上、下固有层的 IgG4 阳性浆细胞/IgG 阳性浆细胞比值（IgG4/IgG 比值）均明显高于其他组。在 AIP-G-ST(-)组中，下固有层的 IgG4/IgG 比值明显高于上固有层，无论 HP 状态如何。总之，固有层弥漫性淋巴浆细胞浸润和胃黏膜中 IgG4/IgG 比值增加（尤其是下固有层）可能是 AIP-G 的特征性发现。
