Is pancreatic core biopsy sufficient to diagnose autoimmune chronic pancreatitis?
Is pancreatic core biopsy sufficient to diagnose autoimmune chronic pancreatitis?
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DOI：
10.1097/mpa.0b013e318135483d
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发表时间：
2008-01-01
期刊：
影响因子：
2.9
通讯作者：
Jang, Se Jin
中科院分区：
文献类型：
--
作者：
Bang, Sung-Jo;Kim, Myung-Hwan;Jang, Se Jin
目的：本研究旨在评估胰腺核心活检在自身免疫性慢性胰腺炎（AIP）的组织学诊断中的充分性。方法：对26例AIP患者胰腺组织标本（经腹部超声引导下行核心活检19例，术中楔形活检3例，手术切除4例）进行组织病理学研究和抗igg4抗体免疫组化染色。8例酒精性慢性胰腺炎患者和10例胰腺癌患者作为对照。结果：在AIP患者中，26%（5/19）的us引导核心活检标本、33%（1/3）的开放活检标本和全部4例切除标本中均观察到淋巴浆细胞性硬化性胰腺炎（LPSP）组织学。对照组中没有患者表现出LPSP的全谱变化。在21%（4/19）的AIP患者行us引导的核心活检标本中，胰腺可见大量igg4阳性细胞（bb10细胞/高倍视野）。8例慢性酒精性胰腺炎患者中2例和10例胰腺癌患者中1例胰腺中也观察到大量igg4阳性细胞。结论：经腹us引导胰腺核心活检可能无法提供足够的组织来评估AIP的特征性组织病理学特征，包括LPSP或大量igg4阳性细胞浸润。LPSP的组织学可能是AIP特异性的，但胰腺中大量的igg4阳性细胞可能不是。
Objectives: This study aimed to evaluate the adequacy of pancreatic core biopsy in histological diagnosis of autoimmune chronic pancreatitis (AIP).Methods: Histopathologic study as well as immunohistochemical staining using anti-IgG4 antibody was done with pancreatic tissue specimens of 26 AIP patients (19 transabdominal ultrasound (US)-guided core biopsies, 3 intraoperative wedge biopsies, and 4 surgical resections). Eight patients with alcoholic chronic pancreatitis and 10 patients with pancreatic cancer served as controls.Results: Lymphoplasmacytic sclerosing pancreatitis (LPSP) histology was observed in 26% (5/19) of US-guided core biopsy specimens, 33% (1/3) of open biopsy specimens, and all 4 resection specimens in AIP patients. None of the patients in the control group showed the full spectrum of changes of LPSP. Abundant IgG4-positive cells (> 10 cells/high-power field) in the pancreas were observed in 21% (4/19) of AIP patients with US-guided core biopsy specimen. Abundant IgG4-positive cells in the pancreas were also observed in 2 of 8 patients with chronic alcoholic pancreatitis and 1 of 10 patients with pancreatic cancer.Conclusions: Transabdominal US-guided pancreatic core biopsy may not provide enough tissue to evaluate characteristic histopathologic features of AIP that include LPSP or abundant IgG4-positive cell infiltration. The LPSP histology may be specific to AIP, but abundant IgG4-positive cells in the pancreas may not.