Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis
Abstract Background/Objectives Autoimmune pancreatitis (AIP) is a diagnosis-challenging disease that often mimics pancreatic malignancy. Pancreatic resection is considered to be a curative treatment for pancreatic ductal adenocarcinoma (PDAC). This meta-analysis aims to study the incidence of AIP in...
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BMC
2024-08-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-024-03367-9 |
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| author | Zain A. Karamya Attila Kovács Dóra Illés Bálint Czakó Alíz Fazekas Nelli Farkas Péter Hegyi László Czakó |
| author_facet | Zain A. Karamya Attila Kovács Dóra Illés Bálint Czakó Alíz Fazekas Nelli Farkas Péter Hegyi László Czakó |
| author_sort | Zain A. Karamya |
| collection | DOAJ |
| description | Abstract Background/Objectives Autoimmune pancreatitis (AIP) is a diagnosis-challenging disease that often mimics pancreatic malignancy. Pancreatic resection is considered to be a curative treatment for pancreatic ductal adenocarcinoma (PDAC). This meta-analysis aims to study the incidence of AIP in patients who have undergone pancreatic resection for clinical manifestation of cancer. Methods A comprehensive search was conducted in three databases, PubMed, Embase and the Cochrane Library, using the terms ‘autoimmune pancreatitis’ and ‘pancreatic resection’ and supplemented by manual checks of reference lists in all retrieved articles. Results Ten articles were included in the final analysis. 8917 pancreatic resections were performed because of a clinical suspicion of pancreatic cancer. AIP accounted for 140 cases (1.6%). Type 1 AIP comprised the majority of cases, representing 94% (132 cases), while type 2 AIP made up the remaining 6% (eight cases) after further classification. AIP accounted for almost 26% of all cases of benign diseases involving unnecessary surgery and was overrepresented in males in 70% of cases compared to 30% in females. The mean age for AIP patients was 59 years. Serum CA 19 − 9 levels were elevated in 23 out of 47 (49%) AIP patients, where higher levels were detected more frequently in patients with type 1 AIP (51%, 22 out of 43) than in those with type 2 AIP (25%, 1 out of 4). The sensitivity of IgG4 levels in type 1 AIP was low (43%, 21/49 patients). Conclusion Even with modern diagnostic methods, distinguishing between AIP and PDAC can still be challenging, thus potentially resulting in unnecessary surgical procedures in some cases. Serum CA 19 − 9 levels are not useful in distinguishing between AIP and PDAC. Work must thus be done to improve diagnostic methods and avoid unnecessary complicated surgery. |
| format | Article |
| id | doaj-art-41c87ee4f18f4615a2f0aac44a057089 |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2024-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-41c87ee4f18f4615a2f0aac44a0570892024-11-24T12:28:33ZengBMCBMC Gastroenterology1471-230X2024-08-0124111110.1186/s12876-024-03367-9Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysisZain A. Karamya0Attila Kovács1Dóra Illés2Bálint Czakó3Alíz Fazekas4Nelli Farkas5Péter Hegyi6László Czakó7Division of Gastroenterology, Department of Medicine, University of SzegedDepartment of Gastroenterology and Internal Medicine, Markusovszky Teaching HospitalDivision of Gastroenterology, Department of Medicine, University of SzegedDivision of Gastroenterology, Department of Medicine, University of SzegedInstitute for Translational Medicine, Medical School, University of PécsInstitute of Bioanalysis, Medical School, University of PécsDivision of Pancreatic Diseases, Heart and Vascular Centre, Semmelweis UniversityDivision of Gastroenterology, Department of Medicine, University of SzegedAbstract Background/Objectives Autoimmune pancreatitis (AIP) is a diagnosis-challenging disease that often mimics pancreatic malignancy. Pancreatic resection is considered to be a curative treatment for pancreatic ductal adenocarcinoma (PDAC). This meta-analysis aims to study the incidence of AIP in patients who have undergone pancreatic resection for clinical manifestation of cancer. Methods A comprehensive search was conducted in three databases, PubMed, Embase and the Cochrane Library, using the terms ‘autoimmune pancreatitis’ and ‘pancreatic resection’ and supplemented by manual checks of reference lists in all retrieved articles. Results Ten articles were included in the final analysis. 8917 pancreatic resections were performed because of a clinical suspicion of pancreatic cancer. AIP accounted for 140 cases (1.6%). Type 1 AIP comprised the majority of cases, representing 94% (132 cases), while type 2 AIP made up the remaining 6% (eight cases) after further classification. AIP accounted for almost 26% of all cases of benign diseases involving unnecessary surgery and was overrepresented in males in 70% of cases compared to 30% in females. The mean age for AIP patients was 59 years. Serum CA 19 − 9 levels were elevated in 23 out of 47 (49%) AIP patients, where higher levels were detected more frequently in patients with type 1 AIP (51%, 22 out of 43) than in those with type 2 AIP (25%, 1 out of 4). The sensitivity of IgG4 levels in type 1 AIP was low (43%, 21/49 patients). Conclusion Even with modern diagnostic methods, distinguishing between AIP and PDAC can still be challenging, thus potentially resulting in unnecessary surgical procedures in some cases. Serum CA 19 − 9 levels are not useful in distinguishing between AIP and PDAC. Work must thus be done to improve diagnostic methods and avoid unnecessary complicated surgery.https://doi.org/10.1186/s12876-024-03367-9Autoimmune pancreatitisPancreaticoduodenectomyPancreatic cancerPancreatic resectionIgG4Whipple’s procedure |
| spellingShingle | Zain A. Karamya Attila Kovács Dóra Illés Bálint Czakó Alíz Fazekas Nelli Farkas Péter Hegyi László Czakó Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis BMC Gastroenterology Autoimmune pancreatitis Pancreaticoduodenectomy Pancreatic cancer Pancreatic resection IgG4 Whipple’s procedure |
| title | Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis |
| title_full | Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis |
| title_fullStr | Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis |
| title_full_unstemmed | Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis |
| title_short | Prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy: a systematic review and meta-analysis |
| title_sort | prevalence of autoimmune pancreatitis in pancreatic resection for suspected malignancy a systematic review and meta analysis |
| topic | Autoimmune pancreatitis Pancreaticoduodenectomy Pancreatic cancer Pancreatic resection IgG4 Whipple’s procedure |
| url | https://doi.org/10.1186/s12876-024-03367-9 |
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