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World J Meta-Anal. May 31, 2019; 7(5): 218-223
Published online May 31, 2019. doi: 10.13105/wjma.v7.i5.218
Present state of endoscopic ultrasonography-guided fine needle aspiration for the diagnosis of autoimmune pancreatitis type 1
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Takuto Hikichi, Hiromasa Ohira
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 960-1247, Japan
Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Minami Hashimoto, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1247, Japan
Author contributions: Sugimoto M designed and performed the study; Sugimoto M, Takagi T and Ohira H analyzed the data; Sugimoto M, Takagi T and Ohira H wrote the paper; Suzuki R, Konno N, Asama H, Hikichi T, Watanabe K, Nakamura J, Takasumi M, Sato Y, Hashimoto M, and Irie H provided clinical advice; Hikichi T and Ohira H supervised the study.
Conflict-of-interest statement: We have no financial relationships to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tadayuki Takagi, MD, PhD, Associate Professor, Doctor, Department of Gastroenterology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1247, Japan. daccho@fmu.ac.jp
Telephone: +81-24-5471202 Fax: +81-24-5472055
Received: March 17, 2019
Peer-review started: March 18, 2019
First decision: April 13, 2019
Revised: April 27, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: May 31, 2019
Processing time: 75 Days and 15.8 Hours
Abstract

Autoimmune pancreatitis (AIP) is defined as pancreatitis caused by irregular narrowing of the pancreatic duct accompanied by pancreatic swelling, fibrosis and lymphocyte infiltration, events that are related to autoimmune mechanisms. The 2010 International Consensus Diagnostic Criteria for AIP defined pancreatitis as “type 1” when increased levels of serum IgG4 were present and other organs were involved; lymphoplasmacytic sclerosing pancreatitis was the main histological characteristic. Apart from surgery, endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is the only method for the histological diagnosis of AIP; however, this method is difficult. The use of larger-diameter FNA needles and trucut biopsy did not improve the diagnostic performance of EUS-FNA, but it has improved gradually. In this review, we look back at past efforts to improve the diagnostic performance of EUS-FNA and reveal the present state of EUS-FNA for the histological diagnosis of AIP type 1.

Keywords: Autoimmune pancreatitis type 1; Endoscopic ultrasonography-guided fine needle aspiration; IgG4-related disease; Lymphoplasmacytic sclerosing pancreatitis

Core tip: Apart from surgery, endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is the only method for the histological diagnosis of autoimmune pancreatitis (AIP). However, this method is difficult. Several attempts to improve the diagnostic performance of EUS-FNA have been undertaken, with gradual success. In this review, we examine past efforts and discuss the present state of EUS-FNA for the histological diagnosis of AIP type 1.