Diagnostic efficay of biopsy in autuimmune pancreatitis

• Project/Area Number: 23790803
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Gastroenterology
• Research Institution: Nagoya City University
• Principal Investigator: NAITOH Itaru 名古屋市立大学, 医学(系)研究科(研究院), 助教 (30527750)
• Project Period (FY): 2011 – 2012
• Project Status: Completed (Fiscal Year 2013)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2012: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2011: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: 自己免疫性膵炎 / IgG4関連疾患 / 生検診断 / IgG4 / 生検

Research Abstract

Our aim was to clarify which of these biopsy specimens and counting method could be a useful tool for supporting the diagnosis of autoimmune pancreatitis(AIP). We retrospectively evaluated biopsy specimens from pancreas, stomach, duodenum, duodenal papilla, colon, liver, bile duct, and minor salivary gland in 36 patients with AIP. The positive IgG4 immunostaining of the duodenal papilla in one high-power field (HPF) showed the highest sensitivity (52%) and accuracy (73%) among the 8 sites. It also showed the highest sensitivity among 4 different counting methods (IgG4 immunostaining in one HPF and 3 HPFs, both IgG4 immunostaining and IgG/IgG4 ratio in one HPF and 3 HPFs), but there were no significant differences with respect to specificity and accuracy.
IgG4 immunostaining of swollen duodenal papilla with more than 10 IgG4-positive plasma cells in at least one HPF is useful for supporting the diagnosis of AIP.

Research Products

• [Journal Article] A comparison of the diagnostic efficacy in type 1 autoimmune pancreatitis based on biopsy specimens from various organs (2014)
  • Author(s): Yamashita H, Naitoh I, Nakazawa T, Hayashi K, Miyabe K, Shimizu S, Kondo M, Nishi Y, Yoshida M, Umemura S, Hori Y, Kato A, Ohara H, Takahashi S, Joh T
  • Journal Title: Pancreatology Volume: Vol14 Issue: 3 Pages: 186-192
  • DOI: 10.1016/j.pan.2014.03.003
  • Peer Reviewed / Open Access
• [Journal Article] Autoimmune pancreatitis presenting a short narrowing of main pancreatic duct with subsequent progression to diffuse pancreatic enlargement over 24 months; natural history of autoimmune pancreatitis (2014)
  • Author(s): Umemura S, Naitoh I, Nakazawa T, Hayashi K, Miyabe K, Shimizu S, Kondo M, Yoshida M, Hori Y, Ohara H, Takahashi S, Joh T
  • Journal Title: JOP Volume: (in press)
  • Peer Reviewed
• [Journal Article] Histological evaluation of obliterative phlebitis for the diagnosis of autoimmune pancreatitis. (2014)
  • Author(s): Miyabe K, Notohara K, Nakazawa T, Hayashi K, Naitoh I, Okumura F, Shimizu S, Yoshida M, Yamashita H, Takahashi S, Ohara H, Joh T
  • Journal Title: J Gastroenterol Volume: 49 Issue: 4 Pages: 715-726
  • DOI: 10.1007/s00535-013-0818-x
  • Peer Reviewed
• [Journal Article] IgG4関連硬化性胆管炎診断における内視鏡の役割 (2014)
  • Author(s): 内藤 格、大原弘隆、中沢貴宏、林 香月、城 卓志
  • Journal Title: 日本消化器内視鏡学会雑誌 Volume: 56 Pages: 433-442
  • NAID: 130003395968
  • Peer Reviewed
• [Journal Article] Diagnosis of IgG4-related sclerosing cholangitis (Review article (2013)
  • Author(s): Takahiro Nakazawa, Itaru Naitoh, Kazuki Hayashi, Katsuyuki Miyabe, Shuya Shimizu,, Takashi Joh
  • Journal Title: World J Gastroenterol Volume: 21 Issue: 43 Pages: 7661-7670
  • DOI: 10.3748/wjg.v19.i43.7661
  • Peer Reviewed
• [Journal Article] Intraductal papillary mucinous neoplasm associated with autoimmune pancreatitis (2013)
  • Author(s): Naitoh I, Nakazawa T, Notohara K, Miyabe K, Hayashi K, Shimizu S, Yoshida M, Yamashita H, Umemura S, Ohara H, Joh T
  • Journal Title: Pancreas Volume: Vol42 Issue: 3 Pages: 552-554
  • DOI: 10.1097/mpa.0b013e31826cc2fc
  • Peer Reviewed
• [Journal Article] Clinical evaluation of international consensus diagnostic criteria for type 1 autoimmune pancreatitis in comparison with Japanese diagnostic criteria 2011. (2013)
  • Author(s): Naitoh I, Nakazawa T, Hayashi K, Miyabe K, Shimizu S, Kondo H, Yoshida M, Yamashita H, Umemura S, Hori Y, Ohara H, Joh T
  • Journal Title: Pancreas Volume: 42 Issue: 8 Pages: 1238-1244
  • DOI: 10.1097/mpa.0b013e318293e628
  • Peer Reviewed
• [Journal Article] Establishment of a Serum IgG4 Cut-off Value for the Differential Diagnosis of IgG4-related Sclerosing Cholangitis- A Japanese Cohort. (2013)
  • Author(s): Ohara H, Nakazawa T, Kawa S, Kamisawa T, Shimosegawa T, Uchida K, Hirano K, Nishino T, Hamano H, Kanno A, Notohara K, Hasebe O, Muraki T, Ishida E, Naitoh I, Okazaki K.
  • Journal Title: J Gastroenterol Hepatol Volume: 28 Issue: 7 Pages: 1247-51
  • DOI: 10.1111/jgh.12248
  • Peer Reviewed
• [Journal Article] Clinical evaluation of International consensus diagnostic criteria for type 1 autoimmune pancreatitis in comparison with Japanese diagnostic criteria 2011 (2013)
  • Author(s): Itaru Naitoh
  • Journal Title: Pancreas Volume: in press
  • Peer Reviewed
• [Journal Article] Diagnostic Criteria for IgG4-related Sclerosing Cholangitis Based on Cholanigiographic Classification (2012)
  • Author(s): Nakazawa T, Ando T, Hayashi K, Naitoh I, Okumura F, Miyabe K, Yoshida M, Shimizu S, Kondo M, Nishi Y, Yoshida M, Yamashita H, Ohara H, Joh T
  • Journal Title: J Gastroenterol Volume: Vol40 Issue: 1 Pages: 79-87
  • DOI: 10.1007/s00535-011-0465-z
  • Peer Reviewed
• [Journal Article] Clinical differences between mass-forming autoimmune pancreatitis and pancreatic cancer (2012)
  • Author(s): Naitoh I, Nakazawa T, Hayashi K, Okumura F, Miyabe K, Shimizu S, Kondo H, Yoshida M, Yamashita H, Ohara H, Joh T
  • Journal Title: Scand J Gastroenterol Volume: Vol47 Issue: 5 Pages: 607-613
  • DOI: 10.3109/00365521.2012.667147
  • Peer Reviewed
• [Journal Article] A Case of IgG4-related Sclerosing Cholangitis Overlapped with Primary Biliary Cirrhosis (2012)
  • Author(s): Naitoh I, Nakazawa T, Hayashi K, Miyabe K, Shimizu S, Yoshida M, Yamashita H, Nojiri S, Takahashi S, Joh T
  • Journal Title: Internal Medicine Volume: 51 Issue: 13 Pages: 1695-1699
  • DOI: 10.2169/internalmedicine.51.7327
  • NAID: 130002062203
  • ISSN: 0918-2918, 1349-7235
  • Peer Reviewed
• [Journal Article] Usefulness of Intraductal Ultrasonography in the Diagnosis of Cholangiocarcinoma and IgG4-Related Sclerosing Cholangitis. (2012)
  • Author(s): Takahiro Nakazawa
  • Journal Title: Clinical endoscopy Volume: 43 Issue: 3 Pages: 331-336
  • DOI: 10.5946/ce.2012.45.3.331
  • Peer Reviewed
• [Journal Article] Intraductal Papillary Mucinous Neoplasm Associated With Autoimmune Pancreatitis (2012)
  • Author(s): Itaru Naitoh
  • Journal Title: Pancreas Volume: 42 Pages: 552-554
  • Peer Reviewed
• [Journal Article] Clinical differences between mass-forming autoimmune pancreatitis and pancreatic cancer. (2012)
  • Author(s): Itaru Naitoh
  • Journal Title: Scand J Gastroenterol Volume: 47 Pages: 607-613
  • Peer Reviewed
• [Journal Article] A case of IgG4-related sclerosing cholangitis overlapping with primary biliary cirrhosis (2012)
  • Author(s): Itaru Naitoh
  • Journal Title: Intern Med Volume: in press
  • NAID: 130002062203
  • Peer Reviewed
• [Journal Article] Diagnostic criteria for IgG4-related sclerosing cholangitis based on cholangiographic classification. (2012)
  • Author(s): Takahiro Nakazawa
  • Journal Title: J Gastroenterol Volume: 47 Pages: 79-87
  • Peer Reviewed
• [Journal Article] Small bile duct involvement in IgG4-related sclerosing cholangitis : liver biopsy and cholangiography correlation (2011)
  • Author(s): Naitoh I, Zen Y, Nakazawa T, Ando T, Hayashi K, Okumura F, Miyabe K, Yoshida M, Nojiri S, Kanematsu T, Ohara H, Joh T
  • Journal Title: J Gastroenterol Volume: Vol46 Issue: 2 Pages: 269-276
  • DOI: 10.1007/s00535-010-0319-0
  • NAID: 10029027508
  • Peer Reviewed
• [Presentation] 1型自己免疫性膵炎診断における生検の有用性―全身8臓器からの生検組織での比較検討― (2014)
  • Author(s): 山下宏章、中沢貴宏
  • Organizer: 第100回日本消化器病学会総会
  • Place of Presentation: 東京
  • Year and Date: 2014-04-25
• [Presentation] 1型自己免疫性膵炎診断における生検の有用性ー全身8臓器からの生検組織での比較検討ー (2014)
  • Author(s): 内藤 格、山下宏章、中沢貴宏
  • Organizer: 第100回消化器内視鏡学会総会
  • Place of Presentation: 東京国際フォーラム（東京都）
• [Presentation] IgG4関連硬化性胆管炎の診断と治療 (2013)
  • Author(s): 内藤格、中沢貴宏、城卓志
  • Organizer: 第55回日本消化器病学会大会
  • Place of Presentation: 東京
  • Year and Date: 2013-10-09
• [Presentation] 自己免疫性膵炎診断における国際コンセンサス基準と改訂診断基準2011の現状と問題 (2013)
  • Author(s): 内藤格、中沢貴宏、大原弘隆、林香月、宮部勝之、清水周哉、近藤啓、吉田道弘、山下宏章、梅村修一郎、堀寧、城卓志
  • Organizer: 第44回日本膵臓学会総会
  • Place of Presentation: 仙台
  • Year and Date: 2013-07-26
• [Presentation] IgG4関連硬化性胆管炎診断における肝生検の有用性-肝生検所見と胆管像の比較を中心に- (2013)
  • Author(s): 内藤格、中沢貴宏、全陽
  • Organizer: 第49回日本肝臓学会総会
  • Place of Presentation: 東京
  • Year and Date: 2013-06-06
• [Presentation] IgG4関連疾患としての自己免疫性膵炎の診断について (2013)
  • Author(s): 内藤格、中沢貴宏、城卓志
  • Organizer: 第99回日本消化器病学会総会
  • Place of Presentation: 鹿児島
  • Year and Date: 2013-03-21
• [Presentation] IgG4関連硬化性胆管炎診断における肝生検の有用性 -肝生検所見と胆管像の比較を中心に- (2013)
  • Author(s): 内藤 格、中沢貴宏、全陽
  • Organizer: 第49回日本肝臓学会総会
  • Place of Presentation: 京王プラザホテル（東京都）
• [Presentation] 自己免疫性膵炎診断における国際コンセンサス基準と改訂診断基準2011の現状と問題 (2013)
  • Author(s): 内藤 格、中沢貴宏、大原弘隆、林 香月、宮部勝之、清水周哉、近藤 啓、吉田道弘、山下宏章、梅村修一郎、堀 寧、城 卓志
  • Organizer: 第44回日本膵臓学会総会
  • Place of Presentation: 仙台国際センター（宮城県）
• [Presentation] IgG4関連硬化性胆管炎の診断と治療 (2013)
  • Author(s): 内藤 格、中沢貴宏、城 卓志
  • Organizer: 第55回日本消化器病学会大会
  • Place of Presentation: グランドプリンスホテル高輪（東京都）
• [Presentation] Endoscopic biliary intraductal ultrasonography and biopsy from IgG4-related sclerosing cholangitis (2013)
  • Author(s): T Nakazawa, I Naitoh, H Ohara
  • Organizer: 第86回消化器内視鏡学会総会
  • Place of Presentation: グランドプリンスホテル高輪（東京都）
• [Presentation] IgG4関連疾患としての自己免疫性膵炎の診断について (2013)
  • Author(s): 内藤 格
  • Organizer: 第99回日本消化器病学会総会
  • Place of Presentation: 城山観光ホテル（鹿児島県）
• [Presentation] 原発性胆汁性肝硬変を合併したIgG4関連硬化性胆管炎の1例 (2012)
  • Author(s): 内藤格、中沢貴宏、林香月、宮部勝之、清水周哉、近藤啓、吉田道弘、山下宏章、城卓志
  • Organizer: 第16回日本肝臓学会大会
  • Place of Presentation: 神戸
  • Year and Date: 2012-10-11
• [Presentation] Endoscopic biliary intraductal ultrasonography and biopsy from bile duct and duodenal papilla in the diagnosis of IgG4-related sclerosing cholangitis (2012)
  • Author(s): Itaru Naitoh, Takahiro Nakazawa, Katsuyuki Miyabe, Kazuki Hayashi, Shuya Shimizu, Hiromu Kondo, Michihiro Yoshida, Hiroaki Yamashita, Shuichiro Umemura, Hirotaka Ohara2), Takashi Joh
  • Organizer: International Digestive Endoscopy Network 2012
  • Place of Presentation: Seoul Korea
  • Year and Date: 2012-07-09
• [Presentation] 腫瘤形成型自己免疫性膵炎と膵癌の鑑別診断 (2012)
  • Author(s): 内藤格、中沢貴宏、大原弘隆
  • Organizer: 第98回日本消化器病学会総会
  • Place of Presentation: 東京
  • Year and Date: 2012-04-20
• [Presentation] 腫瘤形成型自己免疫性膵炎と膵癌の鑑別診断 (2012)
  • Author(s): 内藤 格
  • Organizer: 第98回日本消化器病学会総会
  • Place of Presentation: 京王プラザホテル（東京都）
• [Presentation] Endoscopic biliary intraductal ultrasonography and biopsy from bile duct and duodenal papilla in the diagnosis of IgG4-related sclerosing cholangitis (2012)
  • Author(s): Itaru Naitoh
  • Organizer: International Digestive Endoscopy Network 2012
  • Place of Presentation: Grand Hilton Seoul (Korea)
• [Presentation] 限局性自己免疫性膵炎と膵癌の鑑別診断 (2012)
  • Author(s): 内藤 格
  • Organizer: 第116回日本消化器病学会東海支部例会
  • Place of Presentation: ホテルグリンパーク津（三重県）
• [Presentation] 原発性胆汁性肝硬変を合併したIgG4関連硬化性胆管炎の1例 (2012)
  • Author(s): 内藤 格
  • Organizer: 第16回日本肝臓学会大会
  • Place of Presentation: 神戸国際展示場(兵庫県）
• [Presentation] 自己免疫関連胆道疾患-IgG4関連硬化性胆管炎と原発性硬化性胆管炎の相違点- (2012)
  • Author(s): 内藤 格
  • Organizer: 第117回日本消化器病学会東海支部例会
  • Place of Presentation: 名古屋国際会議場(愛知県）
• [Presentation] Clinical differences between mass-forming autoimmune pancreatitis and pancreatic cancer (2011)
  • Author(s): Naitoh, T.Nakazawa, K.Hayashi, F.Okumura, K.Miyabe, S.Simizu, M.Yoshida, H.Yamashita, H.Ohara, T.Joh
  • Organizer: The International Pancreatic Research Forum 2011
  • Place of Presentation: Osaka Japan
  • Year and Date: 2011-11-26
• [Presentation] IgG4関連全身性疾患の肝胆道病変―IgG4関連硬化性胆管炎と原発性硬化性胆管炎の比較 (2011)
  • Author(s): 内藤格、中澤貴宏、城卓志
  • Organizer: 第53回日本消化器病学会大会
  • Place of Presentation: 福岡
  • Year and Date: 2011-10-22
• [Presentation] IgG4関連硬化性胆管炎と原発性硬化性胆管炎の相違点 (2011)
  • Author(s): 内藤格、中澤貴宏、大原弘隆
  • Organizer: 第96回日本消化器病学会総会
  • Place of Presentation: 東京
  • Year and Date: 2011-05-14
• [Presentation] IgG4関連硬化性胆管炎と原発性硬化性胆管炎の相違点 (2011)
  • Author(s): 内藤 格
  • Organizer: 第97回日本消化器病学会総会
  • Place of Presentation: 京王プラザホテル（東京）
• [Presentation] IgG4関連全身性疾患の肝胆道病変―IgG4関連硬化性胆管炎と原発性硬化性胆管炎の比較 (2011)
  • Author(s): 内藤 格
  • Organizer: 第53回日本消化器病学会大会
  • Place of Presentation: マリンメッセ福岡（福岡）
• [Presentation] Clinical differences between mass-forming autoimmune pancreatitis and pancreatic cancer (2011)
  • Author(s): Itaru Naitoh
  • Organizer: The International Pancreatic Research Forum 2011
  • Place of Presentation: 梅田スカイビル（大阪）