■1型自身免疫性胰腺炎(AIP)是IgG4相关疾病的胰腺表现。然而,这种良性疾病有时会导致胰周血管受累(PVI),这增加了该临床实体的诊断和治疗以及将其与胰腺恶性肿瘤区分开的难度。
■我们回顾了人口统计信息,临床表现,实验室,在我科治疗的101例1型AIP住院患者的影像学和内窥镜检查结果。所有患者根据首次住院医疗资料分为非PVI组和PVI组。进行单变量和多变量分析以分析AIP患者中PVI的潜在预测参数。
■在101名1型AIP患者中,52(51.5%)表现出PVI,男女比例为5.5:1。平均年龄58.37±8.68岁。单因素分析显示胰腺炎病灶的位置,包括胰尾(P=0.010),外周血中存在脾肿大(P=0.001)和白细胞(WBC)数量(P=0.020),与PVI显著相关。胰腺炎病变的位置,包括胰尾(P=0.023),多变量回归分析发现脾肿大(P=0.010)是PVI发展的独立预测因子.PVI组25例患者中有18例接受了皮质类固醇治疗,并进行了不少于6个月的放射学随访,血管病变得到改善。随访期间无一例出现PVI病变加重。非PVI组36例随访时间不超过6个月,只有1例出现PVI。
■这项回顾性研究表明,1型AIP与高比例的PVI相关。胰尾受累和脾肿大可预测1型AIP的PVI。在一部分患者中,PVI病变是可逆的。
UNASSIGNED: Type 1 autoimmune pancreatitis (AIP) is the pancreatic manifestation of IgG4-related disease. However, this benign disease can result in the peripancreatic vascular involvement (PVI) on occasion, which increases the difficulty of diagnosis and treatment of this clinical entity as well as for differentiating it from pancreatic malignancies.
UNASSIGNED: We retrospectively reviewed the information on demographics, clinical presentation, laboratory, imaging and endoscopic findings of 101 hospitalized patients with type 1 AIP treated in our department. All the patients were divided into non-PVI and PVI groups according to the first hospitalized medical data. Univariate and multivariate analyses were performed to analyse the potential predictive parameter(s) of PVI in AIP patients.
UNASSIGNED: Among the 101 type 1 AIP patients, 52 (51.5%) exhibited PVI, with a male/female ratio 5.5:1. Their average age was 58.37±8.68 years old. Univariate analysis revealed that the location of pancreatitis lesions, including the pancreatic tail (P=0.010), the presence of splenomegaly (P=0.001) and the white blood cell (WBC) number in peripheral blood (P=0.020), were significantly associated with PVI. The location of pancreatitis lesions, including the pancreatic tail (P=0.023), and the presence of splenomegaly (P=0.010) were found to be independent predictors of the development of PVI by a multivariable regression analysis. A total of 18 out of 25 patients in PVI group who underwent corticosteroid treatment and no less than 6 months radiological follow-up showed improvement in vascular lesions, and no case exhibited exacerbation of PVI lesions during follow-up. Of 36 patients in non-PVI group who were followed up for no less than 6 months, only one case exhibited PVI.
UNASSIGNED: This retrospective study demonstrated that type 1 AIP was associated with a high proportion of PVI. Pancreatic tail involvement and splenomegaly may predict the PVI in type 1 AIP. PVI lesions are reversible in a subset of patients.