中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2012年
5期
294-298
,共5页
辛磊%彭国林%廖专%胡良皞%常雪娇%朱明华%郑建明%潘春树%沈茜%李兆申
辛磊%彭國林%廖專%鬍良皞%常雪嬌%硃明華%鄭建明%潘春樹%瀋茜%李兆申
신뢰%팽국림%료전%호량호%상설교%주명화%정건명%반춘수%침천%리조신
胰腺炎,自身免疫性%胰腺炎,慢性%疾病特征%IgG4%淋巴浆细胞硬化性胰腺炎
胰腺炎,自身免疫性%胰腺炎,慢性%疾病特徵%IgG4%淋巴漿細胞硬化性胰腺炎
이선염,자신면역성%이선염,만성%질병특정%IgG4%림파장세포경화성이선염
Pancreatitis,autoimmune%Pancreatitis,chronic%Disease attributes%Immunoglobulin G4%Lymphoplasmacytic sclerosing pancreatitis
目的 总结我国自身免疫性胰腺炎(AIP)患者的临床特征.方法 分析上海长海医院2005年2月至2012年5月诊断为AIP的81例患者临床资料.结果 81例AIP患者中男女比例7.1∶1,平均年龄(57±12)岁.51.9％ (42/81)患者以梗阻性黄疸为首发症状.影像学显示胰腺局灶型占位45例,弥漫型肿大35例,胰腺假性囊肿为主要表现1例；72.8％ (59/81)伴有胆管受累,11.1％(5/45)伴有主胰管扩张.PET-CT表现为全胰腺(11例)或胰头颈部(2例)代谢增高,5例伴有胰腺外显著高代谢区.血清IgG4阳性率94.6％(53/56),CA19-9阳性率54.4％(37/68),ss-DNA抗体阳性率14.3％ (4/28),抗核抗体阳性率10.7％(3/28),ds-DNA抗体阳性率7.1％(2/28).20例手术标本行HE染色和IgG4免疫组化染色,均符合淋巴浆细胞硬化性胰腺炎表现.结论 我国AIP以1型为主,结合临床症状,胰腺外表现、影像学和(或)核医学、血清学、细胞学和(或)组织学等检查可有效提高AIP的正确诊断率.
目的 總結我國自身免疫性胰腺炎(AIP)患者的臨床特徵.方法 分析上海長海醫院2005年2月至2012年5月診斷為AIP的81例患者臨床資料.結果 81例AIP患者中男女比例7.1∶1,平均年齡(57±12)歲.51.9％ (42/81)患者以梗阻性黃疸為首髮癥狀.影像學顯示胰腺跼竈型佔位45例,瀰漫型腫大35例,胰腺假性囊腫為主要錶現1例；72.8％ (59/81)伴有膽管受纍,11.1％(5/45)伴有主胰管擴張.PET-CT錶現為全胰腺(11例)或胰頭頸部(2例)代謝增高,5例伴有胰腺外顯著高代謝區.血清IgG4暘性率94.6％(53/56),CA19-9暘性率54.4％(37/68),ss-DNA抗體暘性率14.3％ (4/28),抗覈抗體暘性率10.7％(3/28),ds-DNA抗體暘性率7.1％(2/28).20例手術標本行HE染色和IgG4免疫組化染色,均符閤淋巴漿細胞硬化性胰腺炎錶現.結論 我國AIP以1型為主,結閤臨床癥狀,胰腺外錶現、影像學和(或)覈醫學、血清學、細胞學和(或)組織學等檢查可有效提高AIP的正確診斷率.
목적 총결아국자신면역성이선염(AIP)환자적림상특정.방법 분석상해장해의원2005년2월지2012년5월진단위AIP적81례환자림상자료.결과 81례AIP환자중남녀비례7.1∶1,평균년령(57±12)세.51.9％ (42/81)환자이경조성황달위수발증상.영상학현시이선국조형점위45례,미만형종대35례,이선가성낭종위주요표현1례；72.8％ (59/81)반유담관수루,11.1％(5/45)반유주이관확장.PET-CT표현위전이선(11례)혹이두경부(2례)대사증고,5례반유이선외현저고대사구.혈청IgG4양성솔94.6％(53/56),CA19-9양성솔54.4％(37/68),ss-DNA항체양성솔14.3％ (4/28),항핵항체양성솔10.7％(3/28),ds-DNA항체양성솔7.1％(2/28).20례수술표본행HE염색화IgG4면역조화염색,균부합림파장세포경화성이선염표현.결론 아국AIP이1형위주,결합림상증상,이선외표현、영상학화(혹)핵의학、혈청학、세포학화(혹)조직학등검사가유효제고AIP적정학진단솔.
Objective To analyze the clinical characteristic of Chinese autoimmune pancreatitis (AIP) patients.Methods All clinical data of 81 patients with a diagnosis of AIP in Shanghai Changhai Hospital from February 2005 to May 2012 were analyzed.Results The sex ratio was 7.1∶1 and the mean age was (57± 12) years old in 81 patients with AIP.Obstructive jaundice was the initial symptom in 51.9％ (42/81) patients.In patient receiving CT,focal and diffuse type accounted for 45 and 35 patients.respectively,and pseudocyst was the main manifestation in 1 patient,biliary tract was involved in 59(72.8％ ) patients,dilatation of main pancreatic duct was observed in 5 ( 11.1％ ) patients.In patients receiving PET-CT,diffuse increased Flourine-18 FDG uptake by the pancreas was found in 11 patients,focal increased uptake in 2patients,and significant extra-pancreatic uptake was found in 5 patients.The positive rate of serum IgG4,CA19-9,ss DNA,anti-nuclear antibody and ds-DNA antibody was 94.6％ (53/81),54.4％ (37/68),14.3％ (4/28),10.7％ (3/28),7.1％ (2/28),respectively.The pathological findings of H-E staining and IgG4 immunohistochemical analysis in 20 patients were consistent with lymphoplasmacytic sclerosing pancreatitis.Conclusions Type 1 AIP is the main subtype of AIP in China.Combining clinical symptoms,extra-pancreatic manifestations,imaging or nuclear medicine findings,serology,cytology or histology can effectively increase the correct diagnosis rate of AIP.
