自身免疫性胰腺炎诊断标准及诊疗手段研究进展

Research advances of diagnostic criteria and treatment method of autoimmune pancreatitis

自身免疫性胰腺炎是一种临床少见的疾病,是慢性胰腺炎的特殊类型,也可以是全身免疫性疾病的局部表现,目前普遍认为,自身免疫性胰腺炎的发病机制与自身免疫有关,与之相关的体液免疫、细胞免疫、遗传背景等方面的研究近年来时有报道。自身免疫性胰腺炎的诊断标准主要围绕影像学、血清学、组织学及激素治疗反应等方面。自身免疫性胰腺炎的临床表现较为隐匿且多样,给诊断带来一定困难,但胰腺弥漫性或局限性肿大、胆管狭窄等典型的影像学改变、显著升高的血清IgG水平、淋巴浆细胞浸润的特征性病理表现以及对激素治疗敏感的特点使其能够与普通的慢性胰腺炎、胰腺及胆管恶性肿瘤相鉴别。

Autoimmune pancreatitis is a clinical rare disease,it is a special type of chronic pancreatitis,and sometimes is local feature of systemic autoimmune disease.At present generally considered,the pathogenesis of autoimmune pancreatitis is related of autoimmunity.The research of humoral immunity,cellular immunity,and genetic background of autoimmune pancreatitis are reported in recent years.The diagnostic criteria of autoimmune pancreatitis are related of imaging examinations,serology,histology and reaction of hormonal therapy.The clinical features of autoimmune pancreatitis are occult and varied,which make it difficult to diagnose.But the features of autoimmune pancreatitis,such like pancreatic enlargement existed totally or partially and biliary ducts narrow on their imaging examinations,high serum levels of IgG,lymphoplasmacytic sclerosing and effective of hormonal therapy,make it be possible to differential diagnosis with ordinary chronic pancreatitis,pancreatic and biliary ducts cancer.