title: Does autoimmune pancreatitis increase the risk of pancreatic carcinoma?: a retrospective analysis of pancreatic resections.
abstract: OBJECTIVE
  To estimate the risk of malignancy in autoimmune pancreatitis (AIP).
  
  
  METHODS
  We examined resected pancreata to compare the prevalence of pancreatic intraepithelial neoplasia (PanIN) in 28 cases of AIP and 30 cases of chronic pancreatitis not otherwise specified (CP-NOS). We also reviewed a cohort of 84 AIP cases.
  
  
  RESULTS
  The mean age of the AIP cohort (57 years) was significantly higher than that of the cohort of CP-NOS (47 years) (P = 0.01). Twenty-three cases (82%) of AIP showed PanIN, and 7 cases (25%) showed grade 2 PanIN. Grade 3 PanIN was identified in one case of AIP. There was no statistically significant difference in the number of cases with high-grade PanIN lesions between the cases of type 1 as opposed to type 2 AIP. In comparison to CP-NOS, a comparable percentage of patients with AIP had PanIN (82% of AIP cases vs 63% of CP-NOS cases) (P = NS) and PanIN 2 (25% AIP vs 20% CP-NOS) (P = NS). Of the 84 AIP cases at our institution (mean follow-up, 49 months), 2 cases of pancreatic carcinoma were identified 6 and 10 years after the diagnoses of AIP.
  
  
  CONCLUSIONS
  These findings raise concern that AIP is associated with an elevated risk of malignancy and should prompt additional studies.
authors.affiliation: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
authors.forename: Rajib
authors.initials: R
authors.lastname: Gupta
authors.forename: Arezou
authors.initials: A
authors.lastname: Khosroshahi
authors.forename: Shweta
authors.initials: S
authors.lastname: Shinagare
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandez
authors.forename: Cristina
authors.initials: C
authors.lastname: Ferrone
authors.forename: Gregory Y
authors.initials: GY
authors.lastname: Lauwers
authors.forename: John H
authors.initials: JH
authors.lastname: Stone
authors.forename: Vikram
authors.initials: V
authors.lastname: Deshpande
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications* / Q000378:metabolism; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000209:etiology* / Q000378:metabolism / Q000601:surgery; D010195:Pancreatitis / Q000150:complications* / Q000378:metabolism; D050500:Pancreatitis, Chronic / Q000150:complications / Q000378:metabolism; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D055815:Young Adult
chemical_list: D016159:Tumor Suppressor Protein p53