Okamoto Ayana, Watanabe Tomohiro, Kamata Ken, Minaga Kosuke, Kudo Masatoshi
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan.
Intern Med. 2019 Jun 1;58(11):1533-1539. doi: 10.2169/internalmedicine.2210-18. Epub 2019 Feb 1.
Autoimmune pancreatitis (AIP) is now considered a pancreatic manifestation of a newly proposed disease condition, IgG4-related disease (IgG4-RD). IgG4-RD is characterized by enhanced IgG4 antibody responses and multiple organ involvements. Recent epidemiological studies have addressed the incidence of cancer in patients with AIP and/or IgG4-RD. Surprisingly, a significant number of AIP patients were detected with cancer at or within one year of the diagnosis of AIP. Furthermore, around 50% of all cancers detected in AIP patients comprised mainly 3 types (gastric, lung, and prostate cancer). Thus, AIP appears to be associated with cancer of other organs rather than the pancreas itself, which suggests that AIP is not a pre-cancerous condition of the pancreas. Moreover, the simultaneous occurrence of cancer and AIP in many patients has led to the establishment of an attractive concept that AIP might sometimes arise from co-existing cancers as a paraneoplastic syndrome.
自身免疫性胰腺炎(AIP)现在被认为是一种新提出的疾病——IgG4相关疾病(IgG4-RD)的胰腺表现形式。IgG4-RD的特征是IgG4抗体反应增强和多器官受累。最近的流行病学研究探讨了AIP和/或IgG4-RD患者中癌症的发病率。令人惊讶的是,在AIP诊断时或诊断后一年内,大量AIP患者被检测出患有癌症。此外,在AIP患者中检测到的所有癌症中,约50%主要包括3种类型(胃癌、肺癌和前列腺癌)。因此,AIP似乎与其他器官的癌症有关,而不是与胰腺本身有关,这表明AIP不是胰腺的癌前病变。此外,许多患者中癌症和AIP的同时出现导致了一个有吸引力的概念的形成,即AIP有时可能作为副肿瘤综合征由并存的癌症引起。