对疑似癌症而接受手术的局灶性自身免疫性胰腺炎患者，按照国际共识诊断标准进行的术前诊断与组织学诊断之间的回顾性比较。

Retrospective comparison between preoperative diagnosis by International Consensus Diagnostic Criteria and histological diagnosis in patients with focal autoimmune pancreatitis who underwent surgery with suspicion of cancer.

作者信息

Ikeura Tsukasa, Detlefsen Sönke, Zamboni Giuseppe, Manfredi Riccardo, Negrelli Riccardo, Amodio Antonio, Vitali Francesco, Gabbrielli Armando, Benini Luigi, Klöppel Günter, Okazaki Kazuichi, Vantini Italo, Frulloni Luca

机构信息

From the *The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan; †Department of Pathology, Odense University Hospital, Odense, Denmark; Departments of ‡Pathology, §Radiology, and ∥Medicine, Pancreas Center, University of Verona, Verona, Italy; and ¶Department of Pathology, University of Kiel, Kiel, Germany.

出版信息

Pancreas. 2014 Jul;43(5):698-703. doi: 10.1097/MPA.0000000000000114.

DOI:10.1097/MPA.0000000000000114

PMID:24681878

Abstract

OBJECTIVE

The objective of this study was to compare the preoperative diagnosis by International Consensus Diagnostic Criteria (ICDC) with histological diagnosis in patients with focal autoimmune pancreatitis (AIP) who underwent surgery.

METHODS

Thirty patients (type 1 AIP in 23 and type 2 AIP in 7) with a diagnosis of AIP based on histology of surgical specimens were classified according to ICDC based on their preoperative data.

RESULTS

Pancreatic core biopsies and diagnostic steroid trial were not preoperatively performed in any of the patients. Based on preoperative data, ICDC diagnosed 6 patients (20%) as having type 1 AIP and 24 (80%) as probable AIP. Assuming all patients had responded to a steroid trial preoperatively, ICDC would have diagnosed 8 patients (27%) as having type 1 AIP, 4 (13%) as type 2 AIP, 10 as AIP-not otherwise specified (33%), and 8 (27%) as probable AIP. In the hypothetical situation, 7 of 8 type 1 AIP patients and 3 of 3 type 2 AIP patients would have been classified into the correct subtype of AIP.

CONCLUSIONS

A steroid trial enhances the possibility of correctly diagnosing AIP by ICDC despite the lack of histology. However, some patients cannot be diagnosed as having AIP or be classified into the correct subtype without histology.

摘要

目的

本研究的目的是比较国际共识诊断标准（ICDC）对接受手术的局灶性自身免疫性胰腺炎（AIP）患者的术前诊断与组织学诊断。

方法

30例根据手术标本组织学诊断为AIP的患者（23例1型AIP和7例2型AIP），根据术前数据按照ICDC进行分类。

结果

所有患者术前均未进行胰腺核心活检和诊断性类固醇试验。根据术前数据，ICDC诊断6例患者（20%）为1型AIP，24例（80%）为可能的AIP。假设所有患者术前对类固醇试验均有反应，ICDC将诊断8例患者（27%）为1型AIP，4例（13%）为2型AIP，10例为未另行指定的AIP（33%），8例（27%）为可能的AIP。在这种假设情况下，8例1型AIP患者中的7例和3例2型AIP患者中的3例将被归类为正确的AIP亚型。