Department of General Surgery, University Hospital of Larissa, University of Thessaly, Larissa 41110, Greece.
World J Gastroenterol. 2024 Apr 21;30(15):2091-2095. doi: 10.3748/wjg.v30.i15.2091.
In this editorial we comment on the article by Jaber . Autoimmune pancreatitis (AIP) represents a distinct form of pancreatitis, categorized into AIP-1 and AIP-2, characterized by obstructive jaundice, lymphoplasmacytic infiltrate, and fibrosis. AIP-1, associated with elevated immunoglobulin G4 (IgG4) levels, exhibits higher relapse rates, affecting older males, while AIP-2 is less common and linked to inflammatory bowel disease. AIP is considered a manifestation of IgG4-related systemic disease, sharing characteristic histological findings. Steroids are the primary treatment, with emerging biomarkers like interferon alpha and interleukin-33. AIP poses an increased risk of various malignancies, and the association with pancreatic cancer is debated. Surgery is reserved for severe cases, necessitating careful evaluation due to diagnostic challenges. AIP patients may have concurrent PanINs but display favorable long-term outcomes compared to pancreatic cancer patients. Thorough diagnostic assessment, including biopsy and steroid response, is crucial for informed surgical decisions in AIP.
在这篇社论中，我们对 Jaber 的文章进行了评论。自身免疫性胰腺炎（AIP）代表了一种独特的胰腺炎形式，分为 AIP-1 和 AIP-2，其特征为梗阻性黄疸、淋巴浆细胞浸润和纤维化。与 IgG4 水平升高相关的 AIP-1 复发率更高，影响老年男性，而 AIP-2 则较为少见且与炎症性肠病相关。AIP 被认为是 IgG4 相关系统性疾病的一种表现形式，具有特征性的组织学发现。类固醇是主要的治疗方法，新兴的生物标志物如干扰素 alpha 和白细胞介素-33。AIP 增加了多种恶性肿瘤的风险，与胰腺癌的关联存在争议。手术仅适用于严重病例，由于诊断挑战，需要仔细评估。AIP 患者可能同时存在 PanINs，但与胰腺癌患者相比，其长期预后较好。彻底的诊断评估，包括活检和类固醇反应，对于 AIP 患者的手术决策至关重要。
