Potential for differential diagnosis of autoimmune pancreatitis and pancreatic cancer using carbonic anhydrase II antibody

Pancreas. 2008 Jul;37(1):e1-7. doi: 10.1097/MPA.0b013e318162cb3a.

Abstract

Objectives: Pancreatic ductal epithelia contain an abundance of carbonic anhydrase (CA), and the presence of antibodies to this enzyme has been described in autoimmune disorders. We previously found a small amount of an immunoglobulin G-like material in purchased CAII reagents, which led to pseudopositive reactions.

Methods: We determined the optimum measurement conditions for detecting anti-CAII antibody using an enzyme-linked immunosorbent assay and sera from 140 patients with pancreatic diseases.

Results: Compared with the prevalence of anti-CAII antibody in healthy subjects, a significantly higher seroprevalence of the antibody was detected in patients with autoimmune pancreatitis (AIP) (88.9%, P < 0.02), Sjögren syndrome (67.6%, P < 0.01), and alcoholic chronic pancreatitis (45.8%, P < 0.01). No positive results were obtained among patients with pancreatic cancer. Moreover, the antibody value obtained in the pancreatic cancer patients was actually lower than that obtained in healthy subjects.

Conclusions: The anti-CAII antibody is probably not a specific marker of AIP because it was present at a higher frequency in the sera of patients with other pancreatic diseases. Nevertheless, the anti-CAII antibody may be a useful tool for the differential diagnosis of AIP and pancreatic cancer.

MeSH terms

  • Adult
  • Aged
  • Autoantibodies / blood*
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / enzymology
  • Autoimmune Diseases / immunology
  • Carbonic Anhydrase II / immunology*
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Japan
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / enzymology
  • Pancreatic Neoplasms / immunology*
  • Pancreatitis / diagnosis*
  • Pancreatitis / enzymology
  • Pancreatitis / immunology
  • Pancreatitis, Alcoholic / diagnosis*
  • Pancreatitis, Alcoholic / enzymology
  • Pancreatitis, Alcoholic / immunology
  • Sjogren's Syndrome / diagnosis*
  • Sjogren's Syndrome / enzymology*
  • Sjogren's Syndrome / immunology

Substances

  • Autoantibodies
  • Immunoglobulin G
  • Carbonic Anhydrase II