Differentiation between Autoimmune Pancreatitis and Pancreatic Cancer to Perform Pancreatectomy

Abstract

Background : Autoimmune pancreatitis (AIP) can be difficult to distinguish from cancer of the pancreas when it forms focal lesions.

Methods : The clinical and perioperative data of 34 patients with AIP who were suspected to have pancreatic cancer at our institution were retrospectively analyzed.

Results : Of the 35 patients, 5 (14.7 %) underwent pancreatectomy. In multivariable analyses, serum carbohydrate antigen 19-9 (CA19-9) level (≥37 U/mL) (P=0.01), the absence of extra-pancreatic lesions (P=0.01), and the absence of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) (P<0.01) were independently associated with pancreatectomy for AIP. In univariable analyses, focal pancreatic enlargement (P=0.03) was significantly higher in the surgery group than in the non-surgery group. The findings suspecting vascular invasion (P=0.06) tended to be more frequent in the surgery group than in the non-surgery group.

Conclusions : The present study suggests that the characteristic findings of AIP and the importance of EUS-FNA/ fine-needle biopsy should be reaffirmed to avoid surgery for AIP.