切换至 "中华医学电子期刊资源库"
高级检索
中华肝脏外科手术学电子杂志

中华肝脏外科手术学电子杂志 ›› 2024, Vol. 13 ›› Issue (04) : 492 -497. doi: 10.3877/cma.j.issn.2095-3232.2024.04.009

专家论坛

自身免疫性胰腺炎诊治现状
王天福1, 王刚1,†()   
  1. 1. 150001　哈尔滨医科大学附属第一医院胰胆外科　肝脾外科教育部重点实验室
  • 收稿日期:2024-03-27 出版日期:2024-08-10
  • 通信作者: 王刚
  • 基金资助:
    国家自然科学基金面上项目(82070657，82370651)

Diagnosis and treatment of autoimmune pancreatitis

Tianfu Wang1, Gang Wang1,†()   

  1. 1. Department of Pancreaticobiliary Surgery, Key Laboratory of Liver and Spleen Surgery of the Ministry of Education, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
  • Received:2024-03-27 Published:2024-08-10
  • Corresponding author: Gang Wang
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

王天福, 王刚. 自身免疫性胰腺炎诊治现状[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 492-497.

Tianfu Wang, Gang Wang. Diagnosis and treatment of autoimmune pancreatitis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(04): 492-497.

自身免疫性胰腺炎（autoimmune pancreatitis，AIP）是一种特殊类型的胰腺炎。由于其临床发病率较低，且不同地区流行病学特点不同，故对AIP诊治的认识仍未达成统一。AIP缺乏特异临床症状，早期诊断困难、误诊率高。本文围绕近年来多个AIP诊治指南，同时结合笔者自身的临床经验，对AIP的诊治现状进行探讨、分析，以期为提高其整体治愈率提供参考。

关键词: 自身免疫性胰腺炎, 慢性胰腺炎, 胰腺癌, 诊断, 治疗

Autoimmune pancreatitis (AIP) is a special type of pancreatitis. Due to low clinical incidence and different epidemiological characteristics among regions, no consensus has been reached regarding the understanding of diagnosis and treatment of AIP. Due to lack of specific clinical symptoms, it is difficult to make an early diagnosis and the misdiagnosis rate is relatively high. In this article, based on recent guidelines on the diagnosis and treatment of AIP combined with clinical experience, research progress in the diagnosis and treatment of AIP was reviewed and analyzed, aiming to provide reference for improving the overall cure rate of AIP.

Key words: Autoimmune pancreatitis, Chronic pancreatitis, Pancreatic carcinoma, Diagnosis, Treatment
[1]
Yoshida K, Toki F, Takeuchi T, et al. Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis[J]. Dig Dis Sci, 1995, 40(7):1561-1568.
[2]
Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology[J]. Pancreas, 2011, 40(3):352-358.
[3]
王刚, 丁乙轩, 孙备, 等. 自身免疫性胰腺炎21例临床分析[J]. 中华外科杂志, 2015, 53(9):680-684.
[4]
丁乙轩, 白雪巍, 王刚, 等. 自身免疫性胰腺炎的研究进展[J]. 中华肝胆外科杂志, 2014, 20(11):837-840.
[5]
吴丹, 邱秋, 唐亮, 等. 2009年至2018年我国自身免疫性胰腺炎患者临床特征分析[J]. 中华胰腺病杂志, 2020, 20(5):368-372.
[6]
Fukuda S, Akiyama S, Tarakji A, et al. Prevalence and clinical features of patients with autoimmune pancreatitis and inflammatory bowel disease: a systematic review and meta-analysis[J]. J Gastroenterol Hepatol, 2022, 37(8):1474-1484.
[7]
Nista EC, de Lucia SS, Manilla V, et al. Autoimmune pancreatitis: from pathogenesis to treatment[J]. Int J Mol Sci, 2022, 23(20):12667.
[8]
Song TJ, Kim MH, Moon SH, et al. The combined measurement of total serum IgG and IgG4 may increase diagnostic sensitivity for autoimmune pancreatitis without sacrificing specificity, compared with IgG4 alone[J]. Am J Gastroenterol, 2010, 105(7):1655-1660.
[9]
Chang MC, Liang PC, Jan S, et al. Increase diagnostic accuracy in differentiating focal type autoimmune pancreatitis from pancreatic cancer with combined serum IgG4 and CA19-9 levels[J]. Pancreatology, 2014, 14(5):366-372.
[10]
Jia H, Li J, Huang W, et al. Multimodel magnetic resonance imaging of mass-forming autoimmune pancreatitis: differential diagnosis with pancreatic ductal adenocarcinoma[J]. BMC Med Imaging, 2021, 21(1):149.
[11]
Ogawa H, Takehara Y, Naganawa S. Imaging diagnosis of autoimmune pancreatitis: computed tomography and magnetic resonance imaging[J]. J Med Ultrason, 2021, 48(4):565-571.
[12]
Ha J, Choi SH, Kim KW, et al. MRI features for differentiation of autoimmune pancreatitis from pancreatic ductal adenocarcinoma: a systematic review and meta-analysis[J]. Dig Liver Dis, 2022, 54(7):849-856.
[13]
Choi SY, Kim SH, Kang TW, et al. Differentiating mass-forming autoimmune pancreatitis from pancreatic ductal adenocarcinoma on the basis of contrast-enhanced MRI and DWI findings[J]. AJR Am J Roentgenol, 2016, 206(2):291-300.
[14]
Tang CYL, Chua WM, Cheng LTJ, et al. 18F-FDG PET/CT manifestations of IgG4-related disease[J]. Br J Radiol, 2021, 94(1124):20210105.
[15]
Ohtani M, Ofuji K, Akazawa Y, et al. Clinical usefulness of[18F]-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography for distinguishing between autoimmune pancreatitis and pancreatic cancer[J]. Pancreas, 2021, 50(7):1014-1019.
[16]
Sandrasegaran K, Menias CO. Imaging in autoimmune pancreatitis and immunoglobulin G4-related disease of the abdomen[J]. Gastroenterol Clin North Am, 2018, 47(3):603-619.
[17]
Guo T, Xu T, Zhang S, et al. The role of EUS in diagnosing focal autoimmune pancreatitis and differentiating it from pancreatic cancer[J]. Endosc Ultrasound, 2021, 10(4):280-287.
[18]
Cho MK, Moon SH, Song TJ, et al. Contrast-enhanced endoscopic ultrasound for differentially diagnosing autoimmune pancreatitis and pancreatic cancer[J]. Gut Liver, 2018, 12(5):591-596.
[19]
Okazaki K, Kawa S, Kamisawa T, et al. Amendment of the Japanese consensus guidelines for autoimmune pancreatitis, 2020[J].J Gastroenterol, 2022, 57(4):225-245.
[20]
Kanno A, Masamune A, Fujishima F, et al. Diagnosis of autoimmune pancreatitis by EUS-guided FNA using a 22-gauge needle: a prospective multicenter study[J]. Gastrointest Endosc, 2016, 84(5):797-804, e1.
[21]
Morishima T, Kawashima H, Ohno E, et al. Prospective multicenter study on the usefulness of EUS-guided FNA biopsy for the diagnosis of autoimmune pancreatitis[J]. Gastrointest Endosc, 2016, 84(2):241-248.
[22]
Facciorusso A, Barresi L, Cannizzaro R, et al. Diagnostic yield of endoscopic ultrasound-guided tissue acquisition in autoimmune pancreatitis: a systematic review and meta-analysis[J]. Endosc Int Open, 2021, 9(1):E66-75.
[23]
Ishikawa T, Kawashima H, Ohno E, et al. Usefulness of endoscopic ultrasound-guided fine-needle biopsy for the diagnosis of autoimmune pancreatitis using a 22-gauge Franseen needle: a prospective multicenter study[J]. Endoscopy, 2020, 52(11):978-985.
[24]
Okazaki K, Chari ST, Frulloni L, et al. International consensus for the treatment of autoimmune pancreatitis[J]. Pancreatology, 2017, 17(1):1-6.
[25]
Khosroshahi A, Wallace ZS, Crowe JL, et al. International consensus guidance statement on the management and treatment of IgG4-related disease[J]. Arthritis Rheumatol, 2015, 67(7):1688-1699.
[26]
Hart PA, Topazian MD, Witzig TE, et al. Treatment of relapsing autoimmune pancreatitis with immunomodulators and rituximab: the Mayo Clinic experience[J]. Gut, 2013, 62(11):1607-1615.
[27]
Tacelli M, Celsa C, Magro B, et al. Risk factors for rate of relapse and effects of steroid maintenance therapy in patients with autoimmune pancreatitis: systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2019, 17(6):1061-1072, e8.
[28]
Sano T, Kikuta K, Takikawa T, et al. The M-ANNHEIM-AiP-Activity-Score is useful for predicting relapse in patients with type 1 autoimmune pancreatitis[J]. Pancreatology, 2023, 23(1):112-119.
[29]
de Pretis N, Amodio A, Frulloni L. Updates in the field of autoimmune pancreatitis: a clinical guide[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(7):705-709.
[30]
Hart PA, Levy MJ, Smyrk TC, et al. Clinical profiles and outcomes in idiopathic duct-centric chronic pancreatitis (type 2 autoimmune pancreatitis): the Mayo Clinic experience[J]. Gut, 2016, 65(10):1702-1709.
[31]
Javed AA, Wright MJ, Ding D, et al. Autoimmune pancreatitis: a critical analysis of the surgical experience in an era of modern diagnostics[J]. Pancreas, 2021, 50(4):556-563.
[32]
Meng Q, Xin L, Liu W, et al. Diagnosis and treatment of autoimmune pancreatitis in China: a systematic review[J]. PLoS One, 2015, 10(6):e0130466.
[33]
Kamisawa T, Shimosegawa T, Okazaki K, et al. Standard steroid treatment for autoimmune pancreatitis[J]. Gut, 2009, 58(11):1504-1507.
[34]
Khandelwal A, Inoue D, Takahashi N. Autoimmune pancreatitis: an update[J]. Abdom Radiol, 2020, 45(5):1359-1370.
[35]
徐嘉泽, 胡智明, 杨鸿国, 等. 自身免疫性胰腺炎的诊治进展[J]. 中华普通外科杂志, 2023, 38(1):70-73.
[36]
Tang H, Yang H, Zhang P, et al. Malignancy and IgG4-related disease: the incidence, related factors and prognosis from a prospective cohort study in China[J]. Sci Rep, 2020, 10(1):4910.
[1] 邓呈亮, 陈君哲, 章一新. 继发性肢体淋巴水肿的外科整合治疗[J]. 中华损伤与修复杂志(电子版), 2024, 19(03): 185-191.
[2] 刘连新, 孟凡征. 不断提高腹腔镜解剖性肝切除的规范化[J]. 中华普外科手术学杂志(电子版), 2024, 18(04): 355-358.
[3] 李勇, 彭天明, 王倩倩, 陈育纯, 蒲小勇, 刘久敏. 基于失巢凋亡相关基因的膀胱癌预后模型构建及分析[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 331-339.
[4] 李飞, 郑灶松, 吴芃, 谭万龙. 广东省医学会泌尿外科疑难病例多学科会诊（第16期）——延胡索酸水合酶缺陷型晚期肾细胞癌[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(04): 410-414.
[5] 中华人民共和国国家卫生健康委员会医政司. 原发性肝癌诊疗指南（2024年版）[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 407-449.
[6] 邓小巍, 邵成浩. 胰腺神经内分泌肿瘤转化治疗进展[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 456-460.
[7] 王孜尧, 柯能文. 慢性胰腺炎手术治疗时机与手术方式选择[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 466-471.
[8] 李永政, 孟煜凡, 樊知遥, 展翰翔. 胰腺神经内分泌肿瘤新辅助治疗研究进展[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 481-486.
[9] 武帅, 吴佼星, 王方舟, 杨沛泽, 董顺斌, 王铮, 仵正. 胰腺腺泡细胞癌诊断与治疗[J]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 487-491.
[10] 谭欣, 王鹏源, 胡良皞. 慢性胰腺炎抗炎和抗纤维化治疗的研究进展[J]. 中华消化病与影像杂志(电子版), 2024, 14(04): 289-296.
[11] 马虹宇, 陈元武, 张明明, 岳向勇, 檀碧波. 平胃散加味联合毫火针对直肠癌患者化学治疗致胃肠道反应的疗效[J]. 中华消化病与影像杂志(电子版), 2024, 14(04): 297-300.
[12] 刘燚隆, 党荣广, 艾蓉, 张凯. 肝硬化合并静脉曲张出血患者内镜治疗后再出血风险的模型建立与验证[J]. 中华消化病与影像杂志(电子版), 2024, 14(04): 336-342.
[13] 胡静, 杨秀锦, 侯志云. HBV感染患者外周血ISGs表达水平变化及其与干扰素治疗疗效的关系[J]. 中华消化病与影像杂志(电子版), 2024, 14(04): 343-347.
[14] 袁捷, 乔钰琪, 李彦冬. 二甲双胍、来曲唑联合地屈孕酮治疗多囊卵巢综合征合并不孕症的效果评价[J]. 中华临床医师杂志(电子版), 2024, 18(04): 343-347.
[15] 楚海强, 杨远游, 任刚. 胰腺癌放射治疗联合其他治疗方法的研究进展[J]. 中华临床医师杂志(电子版), 2024, 18(04): 392-396.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号