Suda K, Shiotsu H, Nakamura T, Akai J, Nakamura T
Department of Pathology, Juntendo University, School of Medicine, Tokyo, Japan.
Am J Gastroenterol. 1994 Nov;89(11):2060-2.
To investigate the incidence and histological features of pancreatic fibrosis, including chronic alcoholic pancreatitis, in patients with a history of chronic alcohol abuse.
Forty-six autopsy cases of alcoholic dependence syndrome, 53 cases of chronic alcoholism, and 30 cases of chronic alcoholic pancreatitis were studied histopathologically.
Fibrosis was seen in 33 of 46 cases of alcoholic dependence syndrome, 20 of 53 cases of chronic alcoholism, and all 30 cases of chronic alcoholic pancreatitis. Fibrosis was categorized into three types: intralobular, perilobular, and mixed intralobular and perilobular sclerosis. In chronic alcoholic pancreatitis, fibrosis was found mainly in perilobular, or interlobular, areas, and in some advanced cases extended into intralobular areas, so that the pancreatic tissue was completely replaced by fibrosis. Hence, interlobular fibrosis was found in all cases of chronic alcoholic pancreatitis. In contrast, in cases that had predominantly intralobular fibrosis, which were usually cases of alcoholic dependence syndrome, the pancreatic tissue had not completely disappeared, even at an advanced stage, and some parenchymal regeneration similar to that seen in hemochromatosis was observed.
Interlobular and intralobular pancreatic fibrosis associated with alcohol abuse appears in distinct pathological patterns with differing mechanisms.
调查有慢性酒精滥用史患者胰腺纤维化（包括慢性酒精性胰腺炎）的发病率及组织学特征。
对46例酒精依赖综合征尸检病例、53例慢性酒精中毒病例和30例慢性酒精性胰腺炎病例进行组织病理学研究。
在46例酒精依赖综合征病例中有33例出现纤维化，53例慢性酒精中毒病例中有20例出现纤维化，30例慢性酒精性胰腺炎病例全部出现纤维化。纤维化分为三种类型：小叶内、小叶周围以及小叶内和小叶周围混合性硬化。在慢性酒精性胰腺炎中，纤维化主要见于小叶周围或小叶间区域，在一些晚期病例中扩展至小叶内区域，致使胰腺组织完全被纤维化取代。因此，在所有慢性酒精性胰腺炎病例中均发现小叶间纤维化。相比之下，在以小叶内纤维化为主的病例（通常为酒精依赖综合征病例）中，即使在晚期胰腺组织也未完全消失，并且观察到一些类似于血色素沉着症中所见的实质再生。
与酒精滥用相关的小叶间和小叶内胰腺纤维化呈现出不同的病理模式和机制。
