Schneider Alexander, Hirth Michael, Münch Markus, Weiss Christel, Löhr J Matthias, Ebert Matthias P, Pfützer Roland H
Department of Medicine II, University Medical Centre Mannheim, Medical Faculty of the University of Heidelberg, Mannheim, Germany.
Digestion. 2017;95(2):172-180. doi: 10.1159/000455963. Epub 2017 Feb 23.
BACKGROUND/AIMS: Autoimmune pancreatitis (AIP) has been associated with an increased risk of malignant diseases. We aimed to describe the incidence of malignant diseases in patients with AIP compared to the general population and to characterize the clinical presentation of these patients.
We retrospectively analyzed data from 28 patients with AIP presenting to the clinic (periods 1998 until 2010, 2012 until September 2015). We retrieved the expected cancer incidence of the general population from the German cancer registry. We determined the ratio of patients with malignant disease, characterized the clinical presentation of these patients, and calculated standardized incidence ratios (SIR).
We observed 6 malignant diseases in 5 patients with AIP (non-Hodgkin lymphoma, colon cancer, breast cancer and ovarian carcinoma, breast cancer, bladder cancer, n = 5/28, 17.9%) during an overall observation period of 223 person-years (2,675 months). The overall SIR of cancer in patients with AIP was 17.3 (95% CI 5.9-35.8), and the overall incidence rate of malignant diseases in these patients was significantly increased compared to the expected incidence in the German population (Fisher's exact test, p < 0.001).
The incidence of malignant diseases in patients with AIP is significantly increased compared to the general population. Careful clinical monitoring is required in individuals with AIP to exclude the occurrence of malignancy.
背景/目的:自身免疫性胰腺炎(AIP)与恶性疾病风险增加有关。我们旨在描述AIP患者中恶性疾病的发生率,并与普通人群进行比较,同时对这些患者的临床表现进行特征描述。
我们回顾性分析了28例到诊所就诊的AIP患者的数据(时间段为1998年至2010年,2012年至2015年9月)。我们从德国癌症登记处获取了普通人群的预期癌症发病率。我们确定了患有恶性疾病的患者比例,描述了这些患者的临床表现,并计算了标准化发病率(SIR)。
在223人年(2675个月)的总体观察期内,我们在5例AIP患者中观察到6例恶性疾病(非霍奇金淋巴瘤、结肠癌、乳腺癌和卵巢癌、乳腺癌、膀胱癌,n = 5/28,17.9%)。AIP患者癌症的总体SIR为17.3(95%可信区间5.9 - 35.8),这些患者中恶性疾病的总体发病率与德国人群的预期发病率相比显著增加(Fisher精确检验,p < 0.001)。
与普通人群相比,AIP患者中恶性疾病的发生率显著增加。对AIP患者需要进行仔细的临床监测以排除恶性肿瘤的发生。