Jin Qiwen, Ge Yongpeng, Chen Xixia, Tan Chang, Huang Zhenguo, Wang Bei, Zhang Bo, Peng Qinglin, Wang Xiaodi, Wang Guochun
Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China.
Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
Front Med (Lausanne). 2022 Mar 7;9:771784. doi: 10.3389/fmed.2022.771784. eCollection 2022.
To characterize the clinical features of autoimmune pancreatitis (AIP) in China and compare differences between our Chinese cohort and Western cohorts.
This was a retrospective study of patients with AIP that was carried out in the China-Japan Friendship Hospital between January 2010 and April 2021. We included a total of 50 patients (46 males and 4 females) aged between 27 and 86 years who fulfilled the international Consensus Diagnostic (ICD) Criteria. For comparative purposes, we included data from seven representative Western cohorts.
When comparing Chinese and Western patients, we found that obstructive jaundice was the most frequent initial symptom (68 vs. 43%, < 0.001). Extra-pancreatic organ involvement was more common in Chinese patients (68 vs. 30%, < 0.001). Sclerosing cholangitis was the most frequent extrapancreatic lesion (48 vs. 24%, = 0.001). The elevation of serum IgG4 was more obvious in our cohort (86 vs. 49%, < 0.001). Conversely, the rates of ANA-positivity were significantly higher in Western populations (17 vs. 50%, = 0.006). With regards to imaging, diffuse swelling was significantly more common in China (44 vs. 27%, = 0.021). Steroid therapy was used more frequently in our Chinese patients (84 vs. 59%, = 0.001). The steroid-response rate was also significantly higher in our Chinese patients (85 vs. 54%, = 0.001); However, the rate of resection was higher in Western cohorts (2 vs. 31%, < 0.001). There was no significant difference between the two populations with regards to recurrence rate (33 vs. 33%, = 1.000).
This study identified significant differences between Chinese and Western populations of patients with AIP. Within the Chinese population, AIP was more likely to have jaundice and extra-pancreatic organ involvement, and elevated serum IgG4 levels. Chinese patients were also showed favorable responses to treatment with glucocorticoids.
描述中国自身免疫性胰腺炎（AIP）的临床特征，并比较中国队列与西方队列之间的差异。
这是一项对2010年1月至2021年4月期间在中国-日本友好医院就诊的AIP患者进行的回顾性研究。我们纳入了总共50例年龄在27至86岁之间、符合国际共识诊断（ICD）标准的患者（46例男性和4例女性）。为了进行比较，我们纳入了来自七个有代表性的西方队列的数据。
比较中国和西方患者时，我们发现梗阻性黄疸是最常见的初始症状（68%对43%，P<0.001）。胰腺外器官受累在中国患者中更常见（68%对30%，P<0.001）。硬化性胆管炎是最常见的胰腺外病变（48%对24%，P = 0.001）。我们队列中血清IgG4升高更为明显（86%对49%，P<0.001）。相反，西方人群中ANA阳性率显著更高（17%对50%，P = 0.006）。在影像学方面，弥漫性肿胀在中国明显更常见（44%对27%，P = 0.021）。我们的中国患者更频繁地使用类固醇治疗（84%对59%，P = 0.001）。我们的中国患者类固醇反应率也显著更高（85%对54%，P = 0.001）；然而，西方队列中的切除率更高（2%对31%，P<0.001）。在复发率方面，两组人群之间没有显著差异（33%对33%，P = 1.000）。
本研究确定了中国和西方AIP患者人群之间的显著差异。在中国人群中，AIP更有可能出现黄疸和胰腺外器官受累，以及血清IgG4水平升高。中国患者对糖皮质激素治疗也表现出良好反应。
