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| 1 | IgG4-related sclerosing disease显示文摘Based on histological and immunohistochemical exami-nation of various organs of patients with autoimmune pancreatitis (AIP), a novel clinicopathological entity of IgG4-related sclerosing disease has been proposed. This is a systemic disease that is characterized by ex-tensive IgG4-positive plasma cells and T-lymphocyte inf iltration of various organs. Clinical manifestations are apparent in the pancreas, bile duct, gallbladder, sali-vary gland, retroperitoneum, kidney, lung, and pros-tate, in which tissue fi brosis with obliterative phlebitis is pathologically induced. AIP is not simply pancreatitis but, in fact, is a pancreatic disease indicative of IgG4-related sclerosing diseases. This disease includes AIP, sclerosing cholangitis, cholecystitis, sialadenitis, retro-peritoneal fi brosis, tubulointerstitial nephritis, intersti-tial pneumonia, prostatitis, inflammatory pseudotumor and lymphadenopathy, all IgG4-related. Most IgG4-related sclerosing diseases have been found to be as-sociated with AIP, but also those without pancreatic involvement have been reported. In some cases, only one or two organs are clinically involved, while in oth-ers, three or four organs are affected. The disease occurs predominantly in older men and responds well to steroid therapy. Serum IgG4 levels and immunos-taining with anti-IgG4 antibody are useful in making the diagnosis. Since malignant tumors are frequently suspected on initial presentation, IgG4-related scleros-ing disease should be considered in the differential diagnosis to avoid unnecessary surgery. | Terumi Kamisawa Atsutake Okamoto | 2008 | World Journal of Gastroenterology2008，14，25： | 50 |
| 2 | Endoscopic diagnosis of pancreaticobiliary maljunction显示文摘Pancreaticobiliary maljunction (PBM) is a congenital anomaly defined as a junction of the pancreatic and bile ducts located outside the duodenal wall, usually forming a markedly long common channel. As the action of the sphincter of Oddi does not functionally affect the junction in PBM patients, continuous pancreatobiliary reflux occurs, resulting in a high incidence of biliary cancer. PBM can be divided into PBM with biliary dilatation (congenital choledochal cyst) and PBM without biliary dilatation (maximal diameter of the bile duct ≤ 10 mm). The treatment of choice for PBM is prophylactic surgery before malignant changes can take place. Endoscopic retrograde cholangiopancreatography (ERC P) is the most effective examination method for close obs ervation of the pattern of the junction site. When the communication between the pancreatic and bile ducts is maintained, despite contraction of the sphi ncter on ERCP, PBM is diagnosed. In these pat ients, levels of pancreatic enzymes in the bile are gene rally elevated, due to continuous pancreatobiliary reflux via a long common channel. Magnetic resonance cholangiopancreatography and 3D-computed tomography can diagnose PBM, based on findings of an anomalous union between the common bile duct and the pancreatic duct, in addition to a long common channel. Endoscopic ultrasonography and intraductal ultra sonography can demonstrate the junction outside the duodenal wall, and are useful for the diagnosis of asso ciated biliary cancer. Gallbladder wall thickness on ultra so nography can be a screening test for PBM. | Terumi Kamisawa Kensuke Takuma Fumihide Itokawa Takao Itoi | 2011 | World Journal of Gastrointestinal Endoscopy2011，3，1： | 25 |
| 3 | Diagnostic criteria for autoimmune pancreatitis in Japan显示文摘Autoimmune pancreatitis (AIP) is a particular type of pancreatitis of presumed autoimmune etiology. Currently, AIP should be diagnosed based on combination of clinical, serological, morphological, and histopathological features. When diagnosing AIP, it is most important to differentiate it from pancreatic cancer. Diagnostic criteria for AIP, proposed by the Japan Pancreas Society in 2002 first in the world, were revised in 2006. The criteria are based on the minimum consensus of AIP and aim to avoid misdiagnosing pancreatic cancer as far as possible, but not for screening AIP. The criteria consist of the following radiological, serological, and histopathological items: (1) radiological imaging showing narrowing of the main pancreatic duct and enlargement of the pancreas, which are characteristic of the disease; (2) laboratory data showing abnormally elevated levels of serum γ-globulin, IgG or IgG4, or the presence of autoantibodies; (3) histopathological examination of the pancreas demonstrating marked fibrosis and prominent infiltration of lymphocytes and plasma cells, which is called lymphoplasmacytic sclerosing pancreatitis (LPSP). For a diagnosis of AIP, criterion 1 must be present, together with criterion 2 and/ or criterion 3. However, it is necessary to exclude malignant diseases such as pancreatic or biliary cancer. | Terumi Kamisawa Kazuichi Okazaki Shigeyuki Kawa | 2008 | World Journal of Gastroenterology2008，14，32： | 26 |
| 4 | MRCP and MRI findings in 9 patients with autoimmune pancreatitis显示文摘瞄准:为了评估磁性的回声 cholangiopancreatography (MRCP ) ,与磁性的回声(先生) 一起的调查结果在自体免疫的胰腺炎(AIP ) 想象病人。方法:有 AIP 的九个病人经历了 MRI, MRCP,内视镜后退 cholangiopancreatography (ERCP ) ,计算断层摄影术,和 ultrasonography。在类固醇治疗前后拿的 MRCP 和先生图象被考察并且与另外的成像形式相比。AIP 盒子的 MRCP 调查结果与有胰的头的癌的 10 个盒子的那些相比。结果:在 MRCP 上,在 ERCP 上注意的主要的胰腺的管的缩小的部分没被设想,当主要的胰腺的管的非包含的片断被设想时。近似的主要的胰腺的管的在上游的膨胀的度比在胰腺的癌的情况下看温和。更低的胆汁管的狭窄或阻塞在 8 个病人被检测。先生图象在 T1 加权的先生图象上与减少的信号紧张显示出胰的增大, T2 加权的先生图象上的增加的信号紧张,并且,在 3 个病人,低亚硫酸钠强烈像囊的边界。在类固醇治疗以后,以前没设想主要的胰腺的管的部分被看见,与胆汁管狭窄的改进一起。胰腺的增大减少了,并且 T1 加权、 T2 加权的先生图象上的反常信号紧张成为了 isointense。结论:MRCP 不能区分从与胰腺的癌看见的主要的胰腺的管的狭窄与 AIP 看见的主要的胰腺的管的不规则的变窄。然而,与在 T1 加权、 T2 加权的先生图象上显示出反常信号紧张的胰腺的增大的先生成像一起的 MRCP 调查结果在支持 AIP 的诊断是有用的。 | Terumi Kamisawa Pong-Yui Chen Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto Noriko Kamata | 2006 | World Journal of Gastroenterology2006，12，18： | 23 |
| 5 | Strategy to differentiate autoimmune pancreatitis from pancreas cancer显示文摘Autoimmune pancreatitis (AIP) is a newly described entity of pancreatitis in which the pathogenesis appears to involve autoimmune mechanisms. Based on histological and immunohistochemical examinations of various organs of AIP patients, AIP appears to be a pancreatic lesion reflecting a systemic 'IgG4-related sclerosing disease'. Clinically, AIP patients and patients with pancreatic cancer share many features, such as preponderance of elderly males, frequent initial symptom of painless jaundice, development of new-onset diabetes mellitus, and elevated levels of serum tumor markers. It is of uppermost importance not to misdiagnose AIP as pancreatic cancer. Since there is currently no diagnostic serological marker for AIP, and approach to the pancreas for histological examination is generally difficult, AIP is diagnosed using a combination of clinical, serological, morphological, and histopathological features. Findings suggesting AIP rather than pancreatic cancer include:fluctuating obstructive jaundice; elevated serum IgG4 levels; diffuse enlargement of the pancreas; delayed en- hancement of the enlarged pancreas and presence of a capsule-like rim on dynamic computed tomography; low apparent diffusion coefficient values on diffusion-weighted magnetic resonance image; irregular narrowing of the main pancreatic duct on endoscopic retrograde cholangiopancreatography; less upstream dilatation of the main pancreatic duct on magnetic resonance cholangiopancreatography, presence of other organ involvement such as bilateral salivary gland swelling, retroperitoneal fibrosis and hilar or intrahepatic sclerosing cholangitis; negative work-up for malignancy including endoscopic ultrasound-guided fine needle aspiration; and steroid responsiveness. Since AIP responds dramatically to steroid therapy, accurate diagnosis of AIP can avoid unnecessary laparotomy or pancreatic resection. | Kensuke Takuma Terumi Kamisawa Rajesh Gopalakrishna Seiichi Hara Taku Tabata Yoshihiko Inaba Naoto Egawa Yoshinori Igarashi | 2012 | World Journal of Gastroenterology2012，18，10： | 20 |
| 6 | Importance of early diagnosis of pancreaticobiliary maljunction without biliary dilatation显示文摘AIM:To clarify the strategy for early diagnosis of pancreaticobiliary maljunction(PBM) without biliary dilatation and to pathologically examine gallbladder before cancer develops.METHODS:The anatomy of the union of the pancreatic and bile ducts was assessed by using endoscopic retrograde cholangiopancreatography(ERCP).Patients with a long common channel in which communication between the pancreatic and bile ducts was maintained even during sphincter contraction were diagnosed as having PBM.Of these,patients in which the maximal diameter of the bile duct was less than 10 mm were diagnosed with PBM without biliary dilatation.The process of diagnosing 54 patients with PBM without biliary dilatation was retrospectively investigated.Histopathological analysis of resected gallbladder specimens from 8 patients with PBM without biliary dilatation or cancer was conducted.RESULTS:Thirty-six PBM patients without biliary dilatation were diagnosed with gallbladder cancer after showing clinical symptoms such as abdominal or back pain(n = 16) or jaundice(n = 12).Radical surgery for gallbladder cancer was only possible in 11 patients(31%) and only 4 patients(11%) survived for 5 years.Eight patients were suspected as having PBM without biliary dilatation from the finding of gallbladder wall thickening on ultrasound and the diagnosis was confirmed by ERCP and/or magnetic resonance cholangiopancreatography(MRCP).The median age of these 8 patients was younger by a decade than PBM patients with gallbladder cancer.All 8 patients underwent prophylactic cholecystectomy and bile duct cancer has not occurred.Wall thickness and mucosal height of the 8 resected gallbladders were significantly greater than controls,and hyperplastic changes,hypertrophic muscular layer,subserosal fibrosis,and adenomyomatosis were detected in 7(88%),5(63%),7(88%) and 5(63%) patients,respectively.Ki-67 labeling index was high and K-ras mutation was detected in 3 of 6 patients.CONCLUSION:To detect PBM without biliary dilatation before onset of gallbladder cancer,we should perform MRCP for individuals showing increased gallbladder wall thickness on ultrasound. | Kensuke Takuma Terumi Kamisawa Taku Tabata Seiichi Hara Sawako Kuruma Yoshihiko Inaba Masanao Kurata Goro Honda Koji Tsuruta Shin-ichiro Horiguchi Yoshinori Igarashi | 2012 | World Journal of Gastroenterology2012，18，26： | 13 |
| 7 | Endoscopic hemostasis techniques for upper gastrointestinal hemorrhage: A review显示文摘Upper gastrointestinal hemorrhage (UGIH) is an urgent disease that is often encountered in daily medical practice. Endoscopic hemostasis is currently indispensable for the treatment of UGIH. Initially, when UGIH is suspected, a cause of UGIH is presumed from the medical interview and physical findings. After ample primary treatment, urgent endoscopy is performed. Many methods of endoscopic hemostasis are in wide use, including hemoclip, injection and thermo-coagulation methods. Although UGIH develops from a wide variety of diseases, such as esophageal varices and gastric and duodenal ulcer, hemostasis is almost always possible. Identification of the causative diseases, primary treatment and characteristic features of endoscopic hemostasis are needed to allow appropriate treatment. | Hajime Anjiki Terumi Kamisawa Masaki Sanaka Taro Ishii Yasushi Kuyama | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，2： | 13 |
| 8 | Usefulness of biopsying the major duodenal papilla to diagnose autoimmune pancreatitis:A prospective study using IgG4-immunostaining显示文摘瞄准:检验组织学并且免疫从自体免疫的胰腺炎(AIP ) 的主要十二指肠的乳头状的小突起拿的活体检视标本的组织化学的调查结果病人们。方法:在有 AIP 的 3 个病人并且 5 个控制病人的 resected 胰的主要十二指肠的乳头状的小突起[胰腺的癌(n = 3 ) 并且长期的含酒精的胰腺炎(n = 2 )] 免疫用 anti-CD4-T 房间, CD8-T 房间和 IgG4 抗体被染色。与怀疑的视神经乳头炎与 AIP 和 5 个控制病人从 2 个病人的主要十二指肠的乳头状的小突起拿的钳活体检视标本有希望地在组织化学地检验的十二指肠镜检查和免疫期间被拿。结果:包括许多 CD4 积极或 CD8 积极的 T 淋巴细胞和 IgG4 积极的血浆房间(>or=10/HPF ) 的中等或严重的 lymphoplasmacytic 渗入,与 AIP 在所有 3 个病人的主要十二指肠的乳头状的小突起被观察。一样的调查结果也在与 AIP 从 2 个病人的主要十二指肠的乳头状的小突起拿的活体检视标本,但是在控制被检测,仅仅有一些(<or=3/HPF ) 渗入主要十二指肠的乳头状的小突起的 IgG4 积极的血浆房间。结论:IgG4 积极的血浆房间的丰富的渗入明确地与 AIP 在病人的主要十二指肠的乳头状的小突起被检测。尽管这是初步的研究,从主要十二指肠的乳头状的小突起拿的活体检视标本的 IgG4-immunostaining 可以支持 AIP 的诊断。 | Terumi Kamisawa Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto | 2006 | World Journal of Gastroenterology2006，12，13： | 13 |
| 9 | Diagnosis and clinical implications of pancreatobiliary reflux显示文摘Oddi 的括约肌在远侧的结束被定位胰腺并且胆汁管并且调整胆汁和胰液的流出。一条普通隧道能那么长连接胰腺并且胆汁管在十二指肠的墙外面被定位,,发生在 pancreaticobiliary maljunction (PBM ) ;在如此的情况中,括约肌行动机能上地不影响连接。因为在胰腺的管以内的水疗院压力通常比在胆汁管大,胰液经常倒流进在 PBM 的胆汁的管(pancreatobiliary 倒流) ,导致致癌物在胆道的非位的条件。Pancreatobiliary 倒流能经由次要的十二指肠的乳头状的小突起在胆汁,刺激分泌素的动态磁性的回声 cholangiopancreatography,和 pancreatography 从提高的淀粉酶水平被诊断。最近,没有 PBM, pancreatobiliary 倒流能发生在个人,变得明显。没有 PBM, Pancreatobiliary 倒流可能甚至在一些个人与胆汁的致癌作用有关。因为很少全身的研究与正常 pancreaticobiliary 连接在个人关于 pancreatobiliary 倒流的临床的关联和含意存在,包括适当管理的进一步未来的临床的研究应该被执行。 | Terumi Kamisawa Hajime Anjiki Naoto Egawa Masanao Kurata Goro Honda Kouji Tsuruta | 2008 | World Journal of Gastroenterology2008，14，43： | 12 |
| 10 | Immunoglobulin G4-related gastrointestinal diseases, are they immunoglobulin G4-related diseases?显示文摘In immunoglobulin G4(IgG4)-related disease(RD),organ enlargement or nodular lesions consisting of abundant infiltration of lymphocytes and IgG4-positive plasma cells and fibrosis are seen in various organs.Although infiltration of many IgG4-positive plasma cells is detected in the gastric and colonic mucosa and major duodenal papilla of patients with autoimmune pancreatitis,it cannot be diagnosed as a gastrointestinal lesion involved in IgG4-RD,because none of the following is observed in these lesions:a mass-like formation;dense fibrosis;or obliterative phlebitis.Based on our review of the literature,there appear to be two types of IgG4-related gastrointestinal disease.One is a gastrointestinal lesion showing marked thickening of the wall of the esophagus and stomach,consisting of dense fibrosis with abundant infiltration of IgG4-positive plasma cells,which usually show submucosal spreading.The other is an IgG4-related pseudotumor occurring in gastrointestinal regions such as the stomach,colon,and major duodenal papilla,showing polypoid or mass-like lesions.Most solitary IgG4-related gastrointestinal lesions that are not associated with other IgG4-RD appear to be difficult to diagnose.It is of utmost importance to rule out malignancy.However,these lesions may respond to steroid therapy.To avoid unnecessary resection,IgG4-related gastrointestinal diseases should be considered in the differential diagnosis. | Satomi Koizumi Terumi Kamisawa Sawako Kuruma Taku Tabata Kazuro Chiba Susumu Iwasaki Yuka Endo Go Kuwata Koichi Koizumi Tooru Shimosegawa Kazuichi Okazaki Tsutomu Chiba | 2013 | World Journal of Gastroenterology2013，19，35： | 12 |
| 11 | Pancreatic cancer with a high serum IgG4 concentration显示文摘Differentiation between autoimmune pancreatitis and pancreatic cancer is sometimes difficult. It has been reported that serum IgG4 concentrations are significantly elevated and particularly high (>135 mg/dL) in autoimmune pancreatitis. Measurement of serum IgG4 has become a useful tool for differentiating between autoimmune pancreatitis and pancreatic cancer. However, we present a 74-year-old female with a markedly elevated serum IgG4 (433 mg/dL) who underwent pancreaticoduodenectomy for pancreatic cancer. Elevated serum IgG4 levels continued after the resection. On histology, adenocarcinoma of the pancreas accompanied with moderate lymphoplasmacytic infiltration infiltrated the lower bile duct and duodenum, but there were no findings of autoimmune pancreatitis. Although a small metastasis was detected in one parapancreatic lymph node, regional lymph nodes were swollen. Abundant IgG4-positive plasma cells infiltrated the cancerous areas of the pancreas, but only a few IgG4-positive plasma cells were detected in the noncancerous areas. Pancreatic cancer cells were not immunoreactive for IgG4. An abundant infiltration of IgG4-positive plasma cells was detected in the swollen regional lymph nodes and in the duodenal mucosa. We believe that the serum IgG4 level was elevated in this patient with pancreatic cancer as the result of an IgG4-related systemic disease that had no clinical manifestations other than lymphadenopathy. | Terumi Kamisawa Pong Yui Chen Yuyang Tu Hitoshi Nakajima Naoto Egawa Kouji Tsuruta Atsutake Okamoto Tsunekazu Hishima | 2006 | World Journal of Gastroenterology2006，12，38： | 10 |
| 12 | Sclerosing cholangitis associated with autoimmune pancreatitis differs from primary sclerosing cholangitis显示文摘AIM:To clarify the characteristic features of biliary le-sions in patients with autoimmune pancreatitis(AIP) and compare them with those of primary sclerosing cholangitis(PSC) .METHODS:The clinicopathological characteristics of 34 patients with sclerosing cholangitis(SC) associated with AIP were compared with those of 4 patients with PSC.RESULTS:SC with AIP occurred predominantly in el-derly men.Obstructive jaundice was the most frequent initial symptom in SC with AIP.Only SC patients with AIP had elevated serum IgG4 levels,and sclerosing diseases were more frequent in these patients.SC pa-tients with AIP responded well to steroid therapy.Seg-mental stenosis of the lower bile duct was observed only in SC patients with AIP,but a beaded and pruned-tree appearance was detected only in PSC patients.Dense infi ltration of IgG4-positive plasma cells was de-tected in the bile duct wall and the periportal area,as well as in the pancreas,of SC patients with AIP.CONCLUSION:SC with AIP is distinctly different from PSC.The two diseases can be discriminated based on cholangiopancreatographic findings and serum IgG4 levels. | Terumi Kamisawa Kensuke Takuma Hajime Anjiki Naoto Egawa Masanao Kurata Goro Honda Kouji Tsuruta | 2009 | World Journal of Gastroenterology2009，15，19： | 9 |
| 13 | Consensus of primary care in acute pancreatitis in Japan显示文摘在日本的尖锐胰腺炎的发生正在增加并且每百万张人口从 187 ~ 347 个盒子。盒子命运是 0.2% 为对温和中等,并且 9.0% 为在在 2003 的日本的严重尖锐胰腺炎。在日本的胰腺炎的专家做了与尖锐胰腺炎在病人的早管理集中于实际方面的这个文件。尖锐胰腺炎和严厉层化的正确诊断应该为尖锐胰腺炎的诊断用标准在所有病人被做并且多,因素得分系统尽早由胰的难处理的疾病的研究委员会求婚了。与尖锐胰腺炎诊断的所有病人应该在医院里被管理。血压监视,脉搏和呼吸率,体温,时时尿的体积,和血氧饱和水平在如此的病人的管理是必要的。早精力旺盛的静脉内的水和具有最前的重要性稳定循环动力学。有鸦片剂的足够的疼痛地势也是重要的。在严重尖锐胰腺炎,在一个早阶段的抗菌素的预防静脉内的管理被推荐。一旦尖锐胰腺炎的诊断被证实,朊酶禁止者的管理应该被开始。如果没有肠塞痛并且胃肠的流血的清楚的症状,从早舞台用非肠道的营养喂的肠内的联合被推荐。有严重尖锐胰腺炎的病人应该尽早被转移到 ICU 执行象朊酶的连续地区性的动脉的注入那样的特殊措施禁止者和抗菌素,和连续牙齿过敏过滤。日本政府为难处理的疾病作为关于措施的研究的工程之一为严重尖锐胰腺炎盖住医疗保健开销。 | Makoto Otsuki Masahiko Hirota Shinju Arata Masaru Koizumi Shigeyuki Kawa Terumi Kamisawa Kazunori Takeda Toshihiko Mayumi Motoji Kitagawa Tetsuhide Ito Kazuo Inui Tooru Shimosegawa Shigeki Tanaka Keisho Kataoka Hiromitsu Saisho Kazuichi Okazaki Yosikazu Kuroda Norio Sawabu Yoshifumi Takeyama | 2006 | World Journal of Gastroenterology2006，12，21： | 9 |
| 14 | Autoimmune pancreatitis metachronously associated with retroperitoneal fibrosis with IgG4-positive plasma cell infiltration显示文摘腹膜后纤维变性是纤维组织的稠密的匾的形成在制动火箭腹膜描绘的不平常的混乱,并且它的病原学仍然保持未知。自体免疫的胰腺炎是纤维变性在胰与 IgG4 积极的血浆房间和淋巴细胞和 obliterative 静脉炎的丰富的渗入描绘的慢性胰炎的一种稀罕类型。我们在场在制动火箭的出现以后开发了 10 瞬间的自体免疫的胰腺炎的一个盒子腹纤维变性。resected 制动火箭腹团的组织检查所见是有 IgG4 积极的血浆房间和淋巴细胞和 obliterative 静脉炎的丰富的渗入的显著 periureteral 纤维变性。这些调查结果在这种情况中为制动火箭腹纤维变性和自体免疫的胰腺炎建议普通 pathophysiological 机制。制动火箭腹纤维变性力量的一些盒子是 IgG4 相关的致硬化的疾病的制动火箭腹损害。 | Terumi Kamisawa Pong Yui Chen Hitoshi Nakajima Naoto Egawa | 2006 | World Journal of Gastroenterology2006，12，18： | 8 |
| 15 | Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas显示文摘AIM: As intraductal papillary mucinous neoplasm (IPMN)has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN. METHODS: Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases (adenoma (n = 19)and adenocarcinoma (n = 11). Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3±0.5 years (range, 0.2-20 years).RESULTS: Other 40 malignancies occurred in 28 patients (35%). They were found before (n = 15), at (n = 19) and after (n = 6) the diagnosis of IPMT. Major associated malignancies were gastric cancer (n = 12), colonic cancer (n = 7), esophageal cancer (n = 4), pulmonary cancer (n = 4), and independent pancreatic cancer (n = 3).Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one (3 years after diagnosis of IPMN). Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age (71.9±8.2 vs66.8±9.3, P<0.05), but not to gender or site of the tumor.CONCLUSION: IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN. | Terumi Kamisawa Yuyang Tu Naoto Egawa Hitoshi Nakajima Kouji Tsuruta Atsutake Okamoto | 2005 | World Journal of Gastroenterology2005，11，36： | 8 |
| 16 | Endoscopic approach for diagnosing autoimmune pancreatitis显示文摘It is of utmost importance to differentiate autoimmune pancreatitis(AIP) from pancreatic cancer(PC).Segmental AIP cases are sometimes difficult to differentiate from PC.On endoscopic retrograde cholangio pancreatography,long or skipped irregular narrowing of the main pancreatic duct(MPD),less upstream dilatation of the distal MPD,side branches derived from the narrowed portion of the MPD,absence of obstruction of the MPD,and stenosis of the intrahepatic bile duct suggest AIP rather than PC.Abundant infiltration of IgG4-positive plasma cells is frequently and rather specifically detected in the major duodenal papilla of AIP patients.IgG4-immunostaining of biopsy specimens obtained from the major duodenal papilla is useful for supporting a diagnosis of AIP with pancreatic head involvement.On endoscopic ultrasonography(EUS),hyperechoic spots in the hypoechoic mass and the duct-penetrating sign suggest AIP rather than PC.EUS and intraductal ultrasonography sometimes show wall thickening of the common bile duct even in the segment in which abnormalities are not clearly observed with cholangiography in AIP patients.EUS-guided fine needle aspiration,especially EUS-guided Tru-Cut biopsy,is useful to diagnose AIP,as well as to exclude PC. | Terumi Kamisawa Hajime Anjiki Kensuku Takuma Naoto Egawa Takao Itoi Fumihide Itokawa | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，1： | 6 |
| 17 | Utility of pancreatography for diagnosing autoimmune pancreatitis显示文摘AIM: To identify pancreatographic findings that facilitate differentiating between autoimmune pancreatitis (AIP) and pancreatic cancer (PC) on endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP). METHODS: ERCP findings of 48 AIP and 143 PC patients were compared. Diagnostic accuracies for AIP by ERCP and MRCP were compared in 30 AIP patients. RESULTS: The following ERCP findings suggested a diagnosis of AIP rather than PC. Obstruction of the main pancreatic duct (MPD) was more frequently detected in PC (P < 0.001). Skipped MPD lesions were detected only in AIP (P < 0.001). Side branch derivation from the narrowed MPD was more frequent in AIP (P < 0.001). The narrowed MPD was longer in AIP (P < 0.001), and a narrowed MPD longer than 3 cm was more frequent in AIP (P < 0.001). Maximal diameter of the upstream MPD was smaller in AIP (P < 0.001), and upstream dilatation of the MPD less than 5 mm was more frequent in AIP (P < 0.001). Stenosis of the lower bile duct was smooth in 87% of AIP and irregular in 65% of PC patients (P < 0.001). Stenosis of the intrahepatic or hilar bile duct was detected only in AIP (P = 0.001). On MRCP, diffuse narrowing of the MPD on ERCP was shown as a skipped non-visualized lesion in 50% and faint visualization in 19%, but segmental narrowing of the MPD was visualized faintly in only 14%. CONCLUSION: Several ERCP findings are useful for differentiating AIP from PC. Although MRCP cannot replace ERCP for the diagnostic evaluation of AIP, some MRCP findings support the diagnosis of AIP. | Kensuke Takuma Terumi Kamisawa Taku Tabata Yoshihiko Inaba Naoto Egawa Yoshinori Igarashi | 2011 | World Journal of Gastroenterology2011，17，18： | 6 |
| 18 | Differences between diffuse and focal autoimmune pancreatitis显示文摘AIM:To investigate differences in clinical features between diffuse-and focal-type autoimmune pancreatitis(AIP).METHODS:Based on radiological findings by computed tomography and/or magnetic resonance imaging,we divided 67 AIP patients into diffuse type(D type) and focal type(F type).We further divided F type into head type(H type) and body and/or tail type(B/T type) according to the location of enlargement.Finally,we classified the 67 AIP patients into three groups:D type,H type and B/T type.We compared the three types of AIP in terms of clinical,laboratory,radiological,functional and histological findings and clinical course.RESULTS:There were 34 patients with D-type,19 with H-type and 14 with B/T-type AIP.Although obstructive jaundice was frequently detected in D-typepatients(88%) and H-type patients(68%),no B/T-type patients showed jaundice as an initial symptom(P < 0.001).There were no differences in frequency of abdominal pain,but acute pancreatitis was associated more frequently in B/T-type patients(36%) than in D-type patients(3%)(P = 0.017).Serum immunoglobulin G(IgG)4 levels were significantly higher in D-type patients(median 309 mg/dL) than in B/T-type patients(133.5 mg/dL)(P = 0.042).Serum amylase levels in B/T-type patients(median:114 IU/L) were significantly greater than in H-type patients(72 IU/L)(P = 0.049).Lymphoplasmacytic sclerosing pancreatitis(LPSP) was histologically confirmed in 6 D-type,7 H-type and 4 B/T-type patients;idiopathic duct-centric pancreatitis was observed in no patients.Marked fibrosis and abundant infiltration of CD20-positive B lymphocytes with few IgG4-positive plasma cells were detected in 2 B/T-type patients.Steroid therapy was effective in all 50 patients(31 D type,13 H type and 6 B/T type).Although AIP relapsed during tapering or after stopping steroids in 3 D-type and 3 H-type patients,no patients relapsed in B/T type.During follow-up,radiological features of 6 B/T-type patients were not changed and 1 B/T-type patient improved naturally.CONCLUSION:Clinical features of H-type AIP were similar to those of D-type,but B/T-type differed from D and H types.B/T-type may involve diseases other than LPSP. | Taku Tabata Terumi Kamisawa Kensuke Takuma Seiichi Hara Sawako Kuruma Yoshihiko Inaba | 2012 | World Journal of Gastroenterology2012，18，17： | 6 |
| 19 | Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011显示文摘 | Hisanori Umehara Kazuichi Okazaki Yasufumi Masaki Mitsuhiro Kawano Motohisa Yamamoto Takako Saeki Shoko Matsui Tadashi Yoshino Shigeo Nakamura Shigeyuki Kawa Hideaki Hamano Terumi Kamisawa Toru Shimosegawa Akira Shimatsu Seiji Nakamura Tetsuhide Ito Kenji | 2012 | Modern Rheumatology2012，，1： | 4 |
| 20 | Safety and efficacy of metallic stent for unresectable distal malignant biliary obstruction in elderly patients显示文摘AIM To study the safety of insertion of metallic stents in elderly patients with unresectable distal malignant biliary obstruction.METHODS Of 272 patients with unresectable distal malignant biliary obstruction, 184 patients under the age of 80 were classified into Group A, and 88 subjects aged 80 years or more were classified into Group B. The safety of metallic stent insertion, metal stent patency period, and the obstruction rate were examined in each group.RESULTS In Group B, patients had a significantly worse per-formance status, high blood pressure, heart disease, cerebrovascular disease, and dementia; besides the rate of patients orally administered antiplatelet drugs or anticoagulants tended to be higher(P < 0.05). Metallic stents were successfully inserted in all patients. The median patency period was 265.000 ± 26.779(1-965) d; 252.000 ± 35.998(1-618) d in Group A and 269.000 ± 47.885(1-965) d in Group B, with no significant difference between the two groups. Metallic stent obstruction occurred in 82 of the 272(30.15%) patients; in 53/184(28.80%) patients in Group A and in 29/88(32.95%) of those in Group B, showing no significant difference between the two groups. Procedural accidents due to metal stent insertion occurred in 24/272(8.8%) patients; in 17/184(9.2%) of patients in Group A and in 7/88(8.0%) of those in Group B, with no significant difference between the two groups, either.CONCLUSION These results suggested that metallic stents can be safely inserted to treat unresectable distal malignant biliary obstruction even in elderly patients aged 80 years or more. | Yuji Sakai Tomohisa Iwai Kenji Shimura Katsushige Gon Kazuya Koizumi Masashi Ijima Kazuro Chiba Seigo Nakatani Harutoshi Sugiyama Toshio Tsuyuguchi Terumi Kamisawa Iruu Maetani Mitsuhiro Kida | 2018 | World Journal of Gastroenterology2018，24，1： | 4 |
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