Usefulness of biopsying the major duodenal papilla to diagnose autoimmune pancreatitis: a prospective study using IgG4-immunostaining.
Usefulness of biopsying the major duodenal papilla to diagnose autoimmune pancreatitis: a prospective study using IgG4-immunostaining.
复制标题
十二指肠乳头活检在诊断自身免疫性胰腺炎中的作用：一项使用 IgG4 免疫染色的前瞻性研究。
DOI：
10.1016/j.gie.2006.03.039
复制
发表时间：
2006
影响因子：
4.3
通讯作者：
A. Okamoto
中科院分区：
文献类型：
--
作者：
T. Kamisawa;Y. Tu;H. Nakajima;N. Egawa;K. Tsuruta;A. Okamoto
目的观察自身免疫性胰腺炎（AIP）患者十二指肠乳头活检标本的组织学和免疫组化结果.方法对3例AIP患者和5例对照组（胰腺癌3例，慢性酒精性胰腺炎2例）十二指肠乳头进行免疫组化染色，并与正常对照组比较.对2例AIP患者和5例疑有十二指肠乳头炎的对照组十二指肠乳头进行前瞻性活检和免疫组化检查，发现3例AIP患者的十二指肠乳头均有中、重度的淋巴浆细胞浸润，包括大量的CD 4 ~+或CD 8 ~+ T淋巴细胞和IgG ~ 4 ~+浆细胞（≥10个/HPF）。在2例AIP患者的十二指肠乳头活检标本中也检测到同样的结果，而在对照组中，只有少数（≤3/HPF）IgG 4阳性浆细胞浸润十二指肠乳头。虽然这是一个初步的研究，IgG 4免疫染色活检标本取自十二指肠乳头可能支持AIP的诊断。
AIMTo examine the histological and immunohistochemical findings of biopsy specimens taken from the major duodenal papilla of autoimmune pancreatitis (AIP) patients.METHODSThe major duodenal papilla in the resected pancreas of 3 patients with AIP and of 5 control patients [pancreatic carcinoma (n = 3) and chronic alcoholic pancreatitis (n = 2)] was immunostained using anti-CD4-T cell, CD8-T cell and IgG4 antibodies. Forceps biopsy specimens taken from the major duodenal papilla of 2 patients with AIP and 5 control patients with suspected papillitis were prospectively taken during duodenoscopy and immunohistochemically examined.RESULTSModerate or severe lymphoplasmacytic infiltration including many CD4-positive or CD8-positive T lymphocytes and IgG4-positive plasma cells (≥10/HPF), was observed in the major duodenal papilla of all 3 patients with AIP. The same findings were also detected in the biopsy specimens taken from the major duodenal papilla of 2 patients with AIP, but in controls, there were only a few (≤3/HPF) IgG4-positive plasma cells infiltrating the major duodenal papilla.CONCLUSIONSAn abundant infiltration of IgG4-positive plasma cells is specifically detected in the major duodenal papilla of patients with AIP. Although this is a preliminary study, IgG4-immunostaining of biopsy specimens taken from the major duodenal papilla may support the diagnosis of AIP.