Clinical characteristics, imaging diagnostic accuracy, and prognosis of autoimmune pancreatitis: A real-world study in China

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases Pub Date : 2024-10-30 DOI:10.1111/1751-2980.13316

Yue Liu, Dong Ling Wan, Zheng Hui Yang, Chao Liu, Ya Tao Tu, Yu Ting Liu, Xin Yue Wang, Jia Heng Xu, Meng Ruo Jiang, De Yu Zhang, Chang Wu, Zhen Dong Jin, Zhao Shen Li, Li Qi Sun, Hao Jie Huang

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引用次数: 0

Abstract

Objective

In this study we aimed to comprehensively evaluate the clinical features and treatment outcomes of Chinese patients with autoimmune pancreatitis (AIP) through a single-center real-world study.

Methods

Patients diagnosed with AIP in Changhai Hospital, Naval Medical University from January 2014 to December 2021 were included. Baseline characteristics, laboratory test results, cross-sectional imaging and endoscopic ultrasound (EUS) findings, and long-term follow-up data were obtained. The differences in these characteristics between type 1 and type 2 AIP patients were analyzed.

Results

Among all 320 patients, 271 (84.7%) and 49 (15.3%) had type 1 and type 2 AIP, respectively. The most common initial symptom was abdominal discomfort (58.1%), followed by obstructive jaundice (32.5%). Extrapancreatic organ involvement was identified in 126 (39.4%) patients, with the biliary system being the most commonly involved (36.6%). Elevated serum IgG4 level was rare in type 2 AIP patients. The diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and EUS for definitive and probable AIP were 78.0%, 68.7%, and 80.5%, respectively. EUS-guided tissue acquisition with immunohistochemical staining helped establish a final diagnosis in 39.7% of patients. During the follow-up period of 60 months, 18.6% of patients experienced relapse. The 1-, 3-, and 5-year relapse rates were higher in type 1 AIP patients, with an accumulated rate of 8.0%, 12.6%, and 15.1%, when compared with those with type 2 AIP.

Conclusions

Type 2 AIP is not uncommon in Chinese population. The diagnostic accuracy of CT and EUS for AIP might be superior to that of MRI.

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自身免疫性胰腺炎的临床特征、影像诊断准确性和预后：中国真实世界研究。

研究目的本研究旨在通过单中心真实世界研究，全面评估中国自身免疫性胰腺炎（AIP）患者的临床特征和治疗效果：纳入2014年1月至2021年12月在海军军医大学附属长海医院确诊的自身免疫性胰腺炎患者。方法：纳入 2014 年 1 月至 2021 年 12 月期间在海军军医大学附属长海医院确诊的 AIP 患者，了解其基线特征、实验室检查结果、横断面成像和内镜超声（EUS）检查结果以及长期随访数据。分析了1型和2型AIP患者在这些特征上的差异：在所有 320 名患者中，1 型和 2 型 AIP 患者分别为 271 人（84.7%）和 49 人（15.3%）。最常见的初始症状是腹部不适（58.1%），其次是阻塞性黄疸（32.5%）。126名患者（39.4%）发现胰腺外器官受累，其中胆道系统最常受累（36.6%）。血清 IgG4 水平升高在 2 型 AIP 患者中很少见。计算机断层扫描（CT）、磁共振成像（MRI）和 EUS 对明确和可能的 AIP 的诊断准确率分别为 78.0%、68.7% 和 80.5%。在 EUS 引导下采集组织并进行免疫组化染色有助于确定 39.7% 患者的最终诊断。在 60 个月的随访期间，18.6% 的患者复发。与2型AIP患者相比，1型AIP患者的1年、3年和5年复发率更高，累计复发率分别为8.0%、12.6%和15.1%：结论：2型AIP在中国人群中并不少见。结论：2型AIP在中国人群中并不少见，CT和EUS对AIP的诊断准确性可能优于MRI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Digestive Diseases 医学-胃肠肝病学

CiteScore

5.40

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Digestive Diseases is the official English-language journal of the Chinese Society of Gastroenterology. The journal is published twelve times per year and includes peer-reviewed original papers, review articles and commentaries concerned with research relating to the esophagus, stomach, small intestine, colon, liver, biliary tract and pancreas.