Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan-Korea Symposium on Autoimmune Pancreatitis
Asian diagnostic criteria for autoimmune pancreatitis: consensus of the Japan-Korea Symposium on Autoimmune Pancreatitis
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DOI：
10.1007/s00535-008-2205-6
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发表时间：
2008-01-01
影响因子：
6.3
通讯作者：
Kihara, Yasuyuki
中科院分区：
文献类型：
--
作者：
Otsuki, Makoto;Chung, Jae Bock;Kihara, Yasuyuki
2002年，日本胰腺学会(JPS)在全球率先提出了自身免疫性胰腺炎(AIP)的诊断标准。由于AIP的概念随着AIP病例的积累而改变，日本厚生劳动省提供的顽固性胰腺疾病研究委员会(RCIPD)和JPS于2006年发布了修订的AIP临床诊断标准。韩国峨山医学中心也在2006年提出了AIP的诊断标准。然而，日本和韩国的标准之间存在着微妙但在临床上具有挑战性的差异。这种不一致使得比较不同中心的研究数据和阐明AIR的特征变得困难。为了就AIP达成共识，RCIPD和韩国胰胆病学会建立了以下AIR I-1诊断的亚洲标准。胰腺实质的影像检查显示弥漫性/节段性/局灶性增大的腺体，偶有肿块和/或低密度边缘。I-2。胰胆管的影像研究显示弥漫性/节段性/局灶性胰管狭窄，常伴有胆管狭窄。(诊断时需要I-1和I-2)。II.血清免疫球蛋白或免疫球蛋白G4水平升高，并检测自身抗体。常见淋巴浆细胞浸润和纤维化，伴有丰富的IgG4阳性细胞浸润。当标准I和其他两个标准之一被满足时，或者当组织学显示切除的胰腺中存在淋巴浆细胞性硬化性胰腺炎时，应诊断为AIP。只有在胰胆癌诊断结果为阴性的符合标准I的患者中，胰腺专科医生才能谨慎地应用类固醇治疗的诊断试验。
In 2002, the Japan Pancreas Society (JPS) was the first in the world to propose diagnostic criteria for autoimmune pancreatitis (AIP). Since the concept of AIP has changed with the accumulation of AIP cases, the Research Committee of Intractable Pancreatic Diseases (RCIPD) provided by the Ministry of Health, Labour and Welfare of Japan and the JPS issued revised clinical diagnostic criteria of AIP in 2006. The Asan Medical Center of Korea also proposed diagnostic criteria for AIP in 2006. However, there are subtle but clinically challenging differences between the Japanese and Korean criteria. This inconsistency makes it difficult to compare data in studies from different centers and elucidate the characteristics of AIR To reach a consensus on AIP, the RCIPD and the Korean Society of Pancreatobiliary Diseases established the following Asian criteria for the diagnosis of AIR I-1. Imaging studies of pancreatic parenchyma show a diffuse/segmental/focally enlarged gland, occasionally with a mass and/or a hypoattenuation rim. I-2. Imaging studies of pancreaticobiliary ducts show diffuse/segmental/focal pancreatic ductal narrowing, often with stenosis of the bile duct. (Both I-1 and I-2 are required for diagnosis). II. Elevated level of serum IgG or IgG4, and detection of autoantibodies. III. Common lymphoplasmacytic infiltration and fibrosis, with abundant IgG4-positive cell infiltration. AIP should be diagnosed when criterion I and one of the other two criteria are satisfied, or when histology shows the presence of lymphoplasmacytic sclerosing pancreatitis in the resected pancreas. A diagnostic trial of steroid therapy can be applied carefully by expert pancreatologists only in patients fulfilling criterion I alone with negative diagnostic work-up results for pancreatobiliary cancer.