Catanzaro R, Dimartino A
Dipartimento di Medicina Interna e Patologie Sistemiche, Azienda Ospedaliero-Universitaria, Policlinico-Vittorio Emanuele di Catania, Italia.
Minerva Gastroenterol Dietol. 2012 Jun;58(2):151-66.
Autoimmune pancreatitis (AIP) is a particular form of chronic pancreatitis recognized as clinical entity only in recent decades. Peculiar clinical, serological, histological and radiological features make it different from other types of pancreatitis. The diagnosis of AIP represents a challenge for the clinicians. Particularly in its focal form, it shows several features in common with pancreatic adenocarcinoma. Both of these conditions, in fact, are often associated with obstructive jaundice, cause increase of the volume of the pancreas and can share the radiologic appearance of a focal mass. The autoimmune pancreatitis instead of pancreatic cancer regresses promptly after treatment with oral corticosteroids. Because of the different management of the two diseases a correct differential diagnosis is imperative. From 5% to 21% of AIP cases are diagnosed in patients after pancreatic resection performed for suspected malignancy. Still not identified a specific serological marker of AIP which can allow a definitive diagnosis of the disease. Both the diagnosis of pancreatic cancer as AIP is paid on the basis of different clinical tests: the diagnosis of pancreatic cancer requires imaging studies, laboratory tests and biopsy of the pancreas, while the diagnosis of AIP requires confirmation of the diagnostic histological, serological and radiological criteria, the involvement of other organs and a positive response to treatment with corticosteroids. Recently, three different diagnostic strategies for AIP have been proposed.
自身免疫性胰腺炎（AIP）是一种特殊形式的慢性胰腺炎，直到最近几十年才被确认为一种临床实体。其独特的临床、血清学、组织学和放射学特征使其有别于其他类型的胰腺炎。AIP的诊断对临床医生来说是一项挑战。特别是在其局灶性形式中，它表现出与胰腺腺癌的一些共同特征。事实上，这两种疾病都常伴有梗阻性黄疸，会导致胰腺体积增大，并且在影像学上可能都表现为局灶性肿块。相反，自身免疫性胰腺炎在口服糖皮质激素治疗后会迅速消退，而胰腺癌则不会。由于这两种疾病的治疗方法不同，正确的鉴别诊断至关重要。在因疑似恶性肿瘤而接受胰腺切除的患者中，有5%至21%的病例被诊断为AIP。目前仍未发现一种能够明确诊断AIP的特异性血清学标志物。胰腺癌和AIP的诊断都基于不同的临床检查：胰腺癌的诊断需要影像学检查、实验室检查和胰腺活检，而AIP的诊断需要确认诊断性的组织学、血清学和放射学标准，其他器官的受累情况以及对糖皮质激素治疗的阳性反应。最近，针对AIP提出了三种不同的诊断策略。
