自身免疫性胰腺炎与胰腺癌的鉴别诊断

Distinguishing autoimmune pancreatitis from pancreaticcancer

自身免疫性胰腺炎（AIP）是全身炎症一纤维化的胰腺表现，亦是免疫球蛋白G4相关的硬化性疾病。AIP具有独特的临床症状、影像学、血清学、病理组织学及胰腺外症状特点。AIP的临床特征与胰腺癌有相似之处，但也有区别。特别要强调的是仅以临床表现不能明确鉴别两者。对于AIP的诊断目前有两个不同的诊断标准：美国Mayo中心的临床HISORt诊断标准，以及日本胰腺学会和韩国医学中心提出的亚洲诊断标准。AIP确诊后，主要治疗手段为类固醇类药物治疗，治疗效果较好；但在患者良好反应后类固醇类药物是否作为维持治疗尚有争议。

Autoimmune pancreatitis （AIP） is a pan- creatic manifestation of a systemic fibro-inflammatory process and it is a immunoglobulin G4-related sclerosing disease. The clinical features of AIP in some aspects are similar, but in other aspects are different from those clinical features of pancreatic cancer. It should be emphasized that clinical features alone cannot be used to differentiate AIP from pancreatic cancer with certainty. The 5 cardinal criteria for the diagnosis of AIP are histology, medical imaging, serology, other organ involvement and clinical response to steroid therapy. There are now 2 diag- nostic criteria of AIP： the Mayo Clinic HISORt Criteria and the Asian Diagnostic Criteria by the Japanese Pancreas Society and Asan Medical Center of Korea. Corticosteroid therapy is the mainstay of therapy for AIP. Usually the patient＇s response to steroid treatment is dramatic. It is still controversial whether maintenance steroid therapy should be given to a patient who has responded well to steroid treatment.