{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:59:32Z","timestamp":1790625572749,"version":"4.1.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T00:00:00Z","timestamp":1674604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to explore the clinical characteristics and differential diagnosis of patients with autoimmune pancreatitis (AIP) and pancreatic cancer to prevent misdiagnosis and mistreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The clinical data of patients with AIP with suspected pancreatic or bile duct malignancy and pancreatic cancer were retrospectively analyzed. The risk factors and the diagnostic value of IgG4 and Tbil levels before treatment for AIP was investigated. Moreover, the imaging features and response to hormone therapy were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AIP was commonly observed in men. Compared to patients with pancreatic cancer, the incidence of poor appetite and weight loss and carbohydrate antigen 19-9 (CA19-9) level was lower in patients with AIP, while the immunoglobulin G4 (IgG4) level was higher (<jats:italic>p\u2009<\/jats:italic>&amp;lt;\u20090.05). After treatment, the IgG4 and CA19-9 levels in patients with AIP were decreased (<jats:italic>p\u2009<\/jats:italic>&amp;lt;\u20090.001). IgG4 level before treatment (OR\u2009=\u20092.452, 95%CI: 1.180\u20135.096, <jats:italic>P<\/jats:italic>\u2009=\u20090.016) and total bilirubin (Tbil) level before treatment (OR\u2009=\u20090.992, 95%CI: 0.985\u20130.998, <jats:italic>P<\/jats:italic>\u2009=\u20090.013) were independent risk factors of AIP. Furthermore, the diagnostic value of IgG4 level before treatment, Tbil level before treatment, IgG4\/Tbil before treatment, and a combination of these indicators was high. Moreover, 15 (68.18%) patients with AIP had space-occupying lesions of the pancreas, and 16 (72.73%) had autoimmune cholangitis. Most patients with AIP were sensitive to hormone therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Tbil and IgG4 levels, imaging findings, and hormone therapy reactivity could differentiate AIP from pancreatic cancer. A combination of IgG4, Tbil, and IgG4\/Tbil before treatment might be a promising diagnostic biomarker for AIP.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1017621","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T08:29:23Z","timestamp":1674635363000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Characteristics of mass-forming autoimmune pancreatitis commonly misdiagnosed as a malignant tumor"],"prefix":"10.3389","volume":"10","author":[{"given":"Si","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanlei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiguang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1007\/BF02232341","article-title":"Chronic inflammatory sclerosis of the pancreas\u2013an autonomous pancreatic disease?","volume":"6","author":"Sarles","year":"1961","journal-title":"Am J Dig Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1007\/BF02285209","article-title":"Chronic pancreatitis caused by an autoimmune abnormality. Proposal of the concept of autoimmune pancreatitis","volume":"40","author":"Yoshida","year":"1995","journal-title":"Dig Dis Sci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e0174735","DOI":"10.1371\/journal.pone.0174735","article-title":"Serological characteristics of autoimmune pancreatitis and its differential diagnosis from pancreatic cancer by using a combination of carbohydrate antigen 19-9, globulin, eosinophils and hemoglobin","volume":"12","author":"Yan","year":"2017","journal-title":"PLoS One"},{"key":"B4","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1007\/s00535-018-1440-8","article-title":"Clinical and pathophysiological aspects of type 1 autoimmune pancreatitis","volume":"53","author":"Uchida","year":"2018","journal-title":"J Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.advms.2014.08.003","article-title":"Utility of serum IgG, IgG4 and carbonic anhydrase II antibodies in distinguishing autoimmune pancreatitis from pancreatic cancer and chronic pancreatitis","volume":"59","author":"Talar-Wojnarowska","year":"2014","journal-title":"Adv Med Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pan.2016.12.003","article-title":"International consensus for the treatment of autoimmune pancreatitis","volume":"17","author":"Okazaki","year":"2016","journal-title":"Pancreatology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.pan.2014.04.029","article-title":"Relationship between autoimmune pancreatitis and pancreatic cancer: a single-center experience","volume":"14","author":"Ikeura","year":"2014","journal-title":"Pancreatology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1038\/ajg.2008.89","article-title":"Misdiagnosis of autoimmune pancreatitis: a caution to clinicians","volume":"104","author":"Gardner","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"601","DOI":"10.3748\/wjg.14.601","article-title":"Diagnosis and management of autoimmune pancreatitis: experience from China","volume":"14","author":"Song","year":"2008","journal-title":"World J Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"771784","DOI":"10.3389\/fmed.2022.771784","article-title":"The clinical phenotype of Chinese patients with autoimmune pancreatitis differs significantly from western patients","volume":"9","author":"Jin","year":"2022","journal-title":"Front Med (Lausanne)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1097\/MPA.0b013e3182142fd2","article-title":"International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the international association of pancreatology","volume":"40","author":"Shimosegawa","year":"2011","journal-title":"Pancreas"},{"key":"B12","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1016\/j.reuma.2016.05.009","article-title":"IgG4-related disease: a concise review of the current literature","volume":"13","author":"Ardila-Suarez","year":"2017","journal-title":"Reumatol Clin"},{"key":"B13","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1159\/000353597","article-title":"Clinical features and comprehensive diagnosis of autoimmune pancreatitis in China","volume":"88","author":"Wu","year":"2013","journal-title":"Digestion"},{"key":"B14","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.amjms.2016.08.022","article-title":"Diabetes as first manifestation of autoimmune pancreatitis","volume":"353","author":"Yamada","year":"2017","journal-title":"Am J Med Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1097\/01.mpa.0000250127.18908.38","article-title":"Evaluation of pancreatic endocrine and exocrine function in patients with autoimmune pancreatitis","volume":"34","author":"Ito","year":"2007","journal-title":"Pancreas"},{"key":"B16","doi-asserted-by":"publisher","first-page":"621","DOI":"10.5603\/KP.2013.0130","article-title":"[Peripartum cardiomyopathy, acute autoimmune pancreatitis and periadipose tissue inflammation - autoimmune reaction?","volume":"71","author":"Kobielusz-Gembala","year":"2013","journal-title":"Kardiol Pol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.gtc.2015.10.005","article-title":"Autoimmune pancreatitis: an update on diagnosis and management","volume":"45","author":"Madhani","year":"2016","journal-title":"Gastroenterol Clin North Am"},{"key":"B18","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s11894-012-0246-8","article-title":"Autoimmune pancreatitis: an update on classification, diagnosis, natural history and management","volume":"14","author":"Sah","year":"2012","journal-title":"Curr Gastroenterol Rep"},{"key":"B19","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1016\/j.pan.2018.09.003","article-title":"Diagnosis, treatment and long-term outcome of autoimmune pancreatitis in Sweden","volume":"18","author":"Vujasinovic","year":"2018","journal-title":"Pancreatology"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.1038\/ajg.2017.85","article-title":"Autoimmune pancreatitis in children: characteristic features, diagnosis, and management","volume":"112","author":"Scheers","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"303","DOI":"10.5152\/tjg.2018.17767","article-title":"Igg4 related autoimmune pancreatitis and sclerosing cholangitis","volume":"30","author":"Ufuk","year":"2019","journal-title":"Turk J Gastroenterol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1038\/nrgastro.2010.81","article-title":"Autoimmune pancreatitis and IgG4-related sclerosing disease","volume":"7","author":"Kamisawa","year":"2010","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s00535-010-0221-9","article-title":"Japanese Consensus guidelines for management of autoimmune pancreatitis: iII. Treatment and prognosis of AIP","volume":"45","author":"Kamisawa","year":"2010","journal-title":"J Gastroenterol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"607","DOI":"10.3109\/00365521.2012.667147","article-title":"Clinical differences between mass-forming autoimmune pancreatitis and pancreatic cancer","volume":"47","author":"Naitoh","year":"2012","journal-title":"Scand J Gastroenterol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"461","DOI":"10.5009\/gnl18429","article-title":"Type 2 autoimmune pancreatitis (idiopathic duct-centric pancreatitis) highlighting patients presenting as clinical acute pancreatitis: a single-center experience","volume":"13","author":"Oh","year":"2019","journal-title":"Gut Liver"},{"key":"B26","doi-asserted-by":"publisher","first-page":"245460","DOI":"10.1155\/2015\/245460","article-title":"Prevalence of splanchnic vein thrombosis in pancreatitis: a systematic review and meta-analysis of observational studies","volume":"2015","author":"Xu","year":"2015","journal-title":"Gastroenterol Res Pract"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1111\/jgh.14088","article-title":"Hepatobiliary and pancreatic: pancreatic cancer with elevated serum IgG4 level due to multiple myeloma mimicking localized autoimmune pancreatitis","volume":"33","author":"Kato","year":"2018","journal-title":"J Gastroenterol Hepatol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1177\/0300060517742303","article-title":"Localized autoimmune pancreatitis mimicking pancreatic cancer: case report and literature review","volume":"46","author":"Hsu","year":"2018","journal-title":"J Int Med Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/S2468-1253(18)30121-3","article-title":"Advances in IgG4-related pancreatobiliary diseases","volume":"3","author":"Kamisawa","year":"2018","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1097\/MCG.0000000000000737","article-title":"Autoimmune pancreatitis and inflammatory bowel disease: an updated review","volume":"51","author":"Tsen","year":"2017","journal-title":"J Clin Gastroenterol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1186\/s12885-017-3665-y","article-title":"(18)F- FDG PET\/CT helps differentiate autoimmune pancreatitis from pancreatic cancer","volume":"17","author":"Zhang","year":"2017","journal-title":"BMC Cancer"},{"key":"B32","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1440-1746.2008.05676.x","article-title":"Usefulness of serum IgG4 in the diagnosis and follow up of autoimmune pancreatitis: a systematic literature review and meta-analysis","volume":"24","author":"Morselli-Labate","year":"2009","journal-title":"J Gastroenterol Hepatol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e0130466","DOI":"10.1371\/journal.pone.0130466","article-title":"Diagnosis and treatment of autoimmune pancreatitis in China: a systematic review","volume":"10","author":"Meng","year":"2015","journal-title":"PLoS One"},{"key":"B34","doi-asserted-by":"publisher","first-page":"6225","DOI":"10.3748\/wjg.v12.i38.6225","article-title":"Pancreatic cancer with a high serum IgG4 concentration","volume":"12","author":"Kamisawa","year":"2006","journal-title":"World J Gastroenterol"},{"key":"B35","doi-asserted-by":"publisher","first-page":"48","DOI":"10.5858\/2008-132-48-SIGFLI","article-title":"Serum immunoglobulin G fraction 4 levels in pancreatic cancer: elevations not associated with autoimmune pancreatitis","volume":"132","author":"Raina","year":"2008","journal-title":"Arch Pathol Lab Med"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1111\/j.1572-0241.2007.01264.x","article-title":"Value of serum IgG4 in the diagnosis of autoimmune pancreatitis and in distinguishing it from pancreatic cancer","volume":"102","author":"Ghazale","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1159\/000481938","article-title":"Multifocal mass lesions in autoimmune pancreatitis","volume":"11","author":"Suzumura","year":"2017","journal-title":"Case Rep Gastroenterol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"3177","DOI":"10.21873\/anticanres.13455","article-title":"Predictive factors for elevated postoperative carbohydrate antigen 19-9 levels in patients with resected pancreatic cancer","volume":"39","author":"Takagi","year":"2019","journal-title":"Anticancer Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e018175","DOI":"10.1136\/bmjopen-2017-018175","article-title":"Comparing the diagnostic accuracy of five common tumour biomarkers and CA19-9 for pancreatic cancer: a protocol for a network meta-analysis of diagnostic test accuracy","volume":"7","author":"Ge","year":"2017","journal-title":"BMJ Open"},{"key":"B40","doi-asserted-by":"publisher","first-page":"349","DOI":"10.2214\/AJR.18.20901","article-title":"Utility of CT radiomics features in differentiation of pancreatic ductal adenocarcinoma from normal pancreatic tissue","volume":"213","author":"Chu","year":"2019","journal-title":"AJR Am J Roentgenol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"4520","DOI":"10.1002\/mp.13733","article-title":"Radiomics analysis for the differentiation of autoimmune pancreatitis and pancreatic ductal adenocarcinoma in (18) F-FDG PET\/CT","volume":"46","author":"Zhang","year":"2019","journal-title":"Med Phys"},{"key":"B42","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1007\/s00330-014-3371-y","article-title":"Pancreatic duct abnormalities in focal autoimmune pancreatitis: mR\/MRCP imaging findings","volume":"25","author":"Negrelli","year":"2015","journal-title":"Eur Radiol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.1080\/00365521.2018.1534137","article-title":"The role of EUS-guided fine needle aspiration in autoimmune pancreatitis: a single center prospective study","volume":"53","author":"Cao","year":"2018","journal-title":"Scand J Gastroenterol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1016\/j.giec.2017.06.005","article-title":"The role of endoscopic ultrasound in the diagnosis of autoimmune pancreatitis","volume":"27","author":"Fujii-Lau","year":"2017","journal-title":"Gastrointest Endosc Clin N Am"},{"key":"B45","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1159\/000085277","article-title":"Treating patients with autoimmune pancreatitis: results from a long-term follow-up study","volume":"5","author":"Kamisawa","year":"2005","journal-title":"Pancreatology"},{"key":"B46","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1080\/00365521.2019.1623307","article-title":"Effectiveness of steroid therapy for pancreatic cysts complicating autoimmune pancreatitis and management strategy for cyst-related complications","volume":"54","author":"Kuraishi","year":"2019","journal-title":"Scand J Gastroenterol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1097\/MPA.0000000000001147","article-title":"Prediction and management for relapse of type 1 autoimmune pancreatitis after initial steroid treatment: a long-term follow-up from China","volume":"47","author":"Xin","year":"2018","journal-title":"Pancreas"},{"key":"B48","doi-asserted-by":"publisher","first-page":"3427","DOI":"10.2169\/internalmedicine.3198-19","article-title":"Dramatic improvement of glycemic control by promptly starting steroid therapy at an early stage of autoimmune pancreatitis in a subject with type 2 diabetes","volume":"58","author":"Irie","year":"2019","journal-title":"Intern Med"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1017621\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T08:29:26Z","timestamp":1674635366000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1017621\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,25]]},"references-count":48,"alternative-id":["10.3389\/fsurg.2023.1017621"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2023.1017621","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,25]]},"article-number":"1017621"}}