دورية أكاديمية
أعرض في EDS

A diagnostic strategy to distinguish autoimmune pancreatitis from pancreatic cancer.

التفاصيل البيبلوغرافية
العنوان: A diagnostic strategy to distinguish autoimmune pancreatitis from pancreatic cancer.
المؤلفون: Chari ST; Miles and Shirley Fiterman Center for Digestive Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. chari.suresh@mayo.edu, Takahashi N, Levy MJ, Smyrk TC, Clain JE, Pearson RK, Petersen BT, Topazian MA, Vege SS
المصدر: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2009 Oct; Vol. 7 (10), pp. 1097-103. Date of Electronic Publication: 2009 May 04.
نوع المنشور: Comparative Study; Evaluation Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: W.B. Saunders for the American Gastroenterological Association Country of Publication: United States NLM ID: 101160775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-7714 (Electronic) Linking ISSN: 15423565 NLM ISO Abbreviation: Clin Gastroenterol Hepatol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : W.B. Saunders for the American Gastroenterological Association, 2003-
مواضيع طبية MeSH: Autoimmune Diseases/*diagnosis , Pancreatic Neoplasms/*diagnosis , Pancreatitis/*diagnosis, Aged ; Anti-Inflammatory Agents/therapeutic use ; Diagnosis, Differential ; Female ; Histocytochemistry ; Humans ; Image Interpretation, Computer-Assisted ; Immunoglobulin G/blood ; Male ; Middle Aged ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Radiography ; Steroids/therapeutic use ; Tomography
مستخلص: Background & Aims: Autoimmune pancreatitis (AIP) and pancreatic cancer (PaC) have similar presentations; a diagnostic strategy is needed to distinguish the 2 diseases.
Methods: We compared computed tomography images (for pancreas and other organ involvement), serum IgG4 levels, histology data, and the response to steroids between patients with AIP (n = 48) and those with PaC (n = 100).
Results: Pancreatic imaging findings stratified patients into 3 groups. Group 1 was highly suggestive of AIP, with diffuse pancreatic enlargement without group 3 features (n = 25, 100% AIP). Group 2 was indeterminate, with normal-sized pancreas or focal pancreatic enlargement without group 3 features (n = 20, 75% AIP). Group 3 was highly suggestive of PaC, with presence of >1 low-density mass, pancreatic duct cutoff, or upstream pancreatic atrophy (n = 103, 92% PaC). Although all patients in group 1 had AIP, only 20 of the 25 patients had increased serum IgG4 levels and/or other organ involvement. Of the patients in groups 2 and 3 who did not have cancer, all those with serum IgG4 levels >2-fold the upper limit of normal or a combination of increased serum IgG4 levels and other organ involvement (n = 15) had AIP. In AIP subjects without supportive serologic evidence or other organ involvement (n = 14), diagnosis required pancreatic core biopsy (n = 7), steroid trial (n = 5), or resection (n = 2).
Conclusions: PaC can be distinguished from AIP by pancreatic imaging, measurement of serum IgG4 levels, and determination of other organ involvement. However, a pancreatic core biopsy, steroid trial, or surgery is required for diagnosis in approximately 30% of patients with AIP.
التعليقات: Comment in: Clin Gastroenterol Hepatol. 2009 Oct;7(10):1026-7. (PMID: 19607936)
المشرفين على المادة: 0 (Anti-Inflammatory Agents)
0 (Immunoglobulin G)
0 (Steroids)
تواريخ الأحداث: Date Created: 20090505 Date Completed: 20091216 Latest Revision: 20220410
رمز التحديث: 20240628
DOI: 10.1016/j.cgh.2009.04.020
PMID: 19410017
قاعدة البيانات: MEDLINE
الوصف
تدمد:1542-7714
DOI:10.1016/j.cgh.2009.04.020