Relationship between autoimmune pancreatitis and pancreatic cancer: A single-center experience

Ikeura, Tsukasa; Miyoshi, Hideaki; Uchida, Kazushige; Fukui, Toshiro; Shimatani, Masaaki; Fukui, Yoshihiro; Sumimoto, Kimi; Matsushita, Masayuki; Takaoka, Makoto; Okazaki, Kazuichi

doi:10.1016/j.pan.2014.04.029

Cited by 79 publications

(77 citation statements)

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“…Thus, the risk of malignancy in the pancreaticobiliary system might be increased in individuals with AIP. However, our present analysis as well as several previous studies [2,[29][30][31] did not show an increased prevalence of pancreatic or biliary cancer in patients with AIP.…”

Section: Discussioncontrasting

confidence: 51%

Risk of Cancer in Patients with Autoimmune Pancreatitis: A Single-Center Experience from Germany

Schneider¹,

Hirth²,

Münch³

et al. 2017

Digestion

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Background/Aims: Autoimmune pancreatitis (AIP) has been associated with an increased risk of malignant diseases. We aimed to describe the incidence of malignant diseases in patients with AIP compared to the general population and to characterize the clinical presentation of these patients. Methods: We retrospectively analyzed data from 28 patients with AIP presenting to the clinic (periods 1998 until 2010, 2012 until September 2015). We retrieved the expected cancer incidence of the general population from the German cancer registry. We determined the ratio of patients with malignant disease, characterized the clinical presentation of these patients, and calculated standardized incidence ratios (SIR). Results: We observed 6 malignant diseases in 5 patients with AIP (non-Hodgkin lymphoma, colon cancer, breast cancer and ovarian carcinoma, breast cancer, bladder cancer, n = 5/28, 17.9%) during an overall observation period of 223 person-years (2,675 months). The overall SIR of cancer in patients with AIP was 17.3 (95% CI 5.9-35.8), and the overall incidence rate of malignant diseases in these patients was significantly increased compared to the expected incidence in the German population (Fisher's exact test, p < 0.001). Conclusion: The incidence of malignant diseases in patients with AIP is significantly increased compared to the general population. Careful clinical monitoring is required in individuals with AIP to exclude the occurrence of malignancy.

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Section: Discussioncontrasting

confidence: 51%

Risk of Cancer in Patients with Autoimmune Pancreatitis: A Single-Center Experience from Germany

Schneider¹,

Hirth²,

Münch³

et al. 2017

Digestion

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“…Ikeura et al [14] reported that out of 69 patients with type 1 AIP, pancreatic cancer developed in three patients during the mean follow-up of 62.4 months. It was concluded that, as with normal chronic pancreatitis, monitoring for cancer is needed in AIP.…”

Section: Discussionmentioning

confidence: 99%

A case of concurrent pancreatic intraepithelial neoplasia and type 1 autoimmune pancreatitis with marked pancreatic duct dilatation

Takano

Nagahama

Yamamura

et al. 2016

Clin J Gastroenterol

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The case patient was a previously healthy 82-year-old male. Abdominal ultrasound during a medical check-up revealed a dilatation of the main pancreatic duct, and the patient was referred to our hospital for closer examination. Contrast-enhanced computed tomography (CT) revealed a low-density mass of 20 mm in the pancreatic head-body transitional area. Magnetic resonance cholangiopancreatography (MRCP) revealed marked dilatation of the main pancreatic duct and branches in the body-tail. On endoscopic ultrasonography (EUS), a hypoechoic mass with irregular shape was detected, which was consistent with the area of pancreatic duct stenosis. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and pancreatic juice cytology were performed; however, there were no malignant findings. Serum IgG4 levels had increased to 299 mg/dL. Cancer of the pancreatic head was suspected and a pancreaticoduodenectomy was thus performed. Macroscopic findings included a white mass with indistinct border in the constricted part of the pancreatic duct and mottled fatty replacement of the pancreatic head. Pathologically, a large amount of IgG4-positive plasma cells was found in the white mass, with storiform fibrosis and obstructive phlebitis, which led to the diagnosis of type 1 autoimmune pancreatitis (AIP). Furthermore, scattered low-high grade pancreatic intraepithelial neoplasia lesions were observed throughout the pancreatic head, separately from the AIP lesion. This is an interesting case that suggests an association between AIP and pancreatic cancer. We report the case with a review of relevant literature.

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“…In a UK study, 6% of patients with AIP and/or IgG4-SC were diagnosed with a malignancy during a median follow-up of 33 months with an incidence ratio for all cancers of 2.25 (95% CI 1.23 to 3.94, p=0.02) compared with the general population 14. In a multicentre, retrospective cohort study, AIP was associated with an increased risk of pancreatic cancer in the first year after diagnosis66 and another Japanese study reported annual incident rate of pancreatic cancer in type 1 AIP to be 0.92% 67. Despite the reported association of pancreatic cancer in type 1 AIP, the role of surveillance during follow-up is not clear.…”

Section: Prognosis and Cancer Riskmentioning

confidence: 99%

Diagnosis and management of IgG4-related disease

Hegade

Sheridan

Huggett

2018

Frontline Gastroenterol

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IgG subclass 4-related disease (IgG4-RD) is a rare but increasingly recognised fibroinflammatory condition known to affect multiple organs. IgG4-RD is characterised by unique histological features of lymphoplasmacytic infiltration, storiform fibrosis and obliterative phlebitis. In this review we describe the pancreaticobiliary manifestations of IgG4-RD, with particular emphasis on type 1 autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-SC). AIP and IgG4-SC can pose diagnostic challenges to the clinician as they may mimic pancreatic cancer and primary sclerosing cholangitis, respectively. We discuss current knowledge, clinical diagnostic criteria and recent advances and summarise the evidence base for current therapeutic approaches for AIP and IgG4-SC.

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Relationship between autoimmune pancreatitis and pancreatic cancer: A single-center experience

Abstract: Similar to patients with ordinary CP, surveillance for development of PaC is needed at regular interval during follow-up in AIP patients.

Cited by 79 publications

References 50 publications

Risk of Cancer in Patients with Autoimmune Pancreatitis: A Single-Center Experience from Germany

Risk of Cancer in Patients with Autoimmune Pancreatitis: A Single-Center Experience from Germany

A case of concurrent pancreatic intraepithelial neoplasia and type 1 autoimmune pancreatitis with marked pancreatic duct dilatation

Diagnosis and management of IgG4-related disease

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