From the Departments of *Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; and †Department of Community-Based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Pancreas. 2013 Nov;42(8):1238-44. doi: 10.1097/MPA.0b013e318293e628.
The objective of this study was to evaluate the International Consensus Diagnostic Criteria (ICDC) for type 1 autoimmune pancreatitis (AIP) in comparison with the Japanese criteria 2011 (JPS2011).
We retrospectively investigated the usefulness of ICDC in comparison with JPS2011 in 64 patients with AIP and 90 patients with pancreatic cancer.
The sensitivity and specificity of ICDC for AIP were 98.4% (63/64) and 100% (90/90), respectively. The sensitivities and specificities of ductal imaging, serology, other organ involvement, and pancreatic histology were 74.1%, 89.1%, 53.1%, and 26.1% and 94.7%, 94.5%, 100%, and 100%, respectively. On the other hand, the sensitivities and specificities of JPS2011 for AIP were 84.4% (54/64) and 100% (90/90), respectively. The condition of all the 10 patients who were deniable or possible under the JPS2011 could be diagnosed as definitive AIP under the ICDC. The sensitivities and specificities of Japanese criteria 2006, Asian Diagnostic Criteria, and HISORt criteria were 80.6%, 84.4%, and 92.2% and 95.8%, 87.8%, and 100%, respectively.
The sensitivity and specificity of ICDC are higher than those of previous criteria. The JPS2011 is easy to handle for general practice, and specificity is very high. However, the sensitivity of JPS2011 is lower than that of ICDC, and improvement of sensitivity is to be hoped in the future.
本研究旨在评估国际共识诊断标准（ICDC）在诊断 1 型自身免疫性胰腺炎（AIP）方面与日本标准 2011 年版（JPS2011）的比较。
我们回顾性地研究了 ICDC 在诊断 64 例 AIP 患者和 90 例胰腺癌患者中的应用，并与 JPS2011 进行了比较。
ICDC 对 AIP 的敏感性和特异性分别为 98.4%（63/64）和 100%（90/90）。胰管成像、血清学、其他器官受累和胰腺组织学的敏感性和特异性分别为 74.1%、89.1%、53.1%和 26.1%，94.7%、94.5%、100%和 100%。另一方面，JPS2011 对 AIP 的敏感性和特异性分别为 84.4%（54/64）和 100%（90/90）。JPS2011 无法确诊的 10 例患者，按照 ICDC 标准可诊断为明确的 AIP。日本标准 2006 年版、亚洲诊断标准和 HISORt 标准的敏感性和特异性分别为 80.6%、84.4%和 92.2%和 95.8%、87.8%和 100%。
ICDC 的敏感性和特异性均高于以往的标准。JPS2011 易于临床实践，特异性非常高。然而，JPS2011 的敏感性低于 ICDC，未来希望提高其敏感性。
