Chronic atrophic gastritis: focus on diagnosis

I. Bakulin, A. G. Sushilova, A. V. Zharkov
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Abstract

Currently, chronic atrophic gastritis is a risk factor for the development of gastric cancer. Data on the prevalence of chronic atrophic gastritis in Russia and the world are limited. Among the adult population of St. Petersburg aged 21 to 81 years, the prevalence of histologically verified chronic atrophic gastritis is 5.3%. Moreover, the chances of developing chronic atrophic gastritis in people over the age of 60 years compared to the group of 45–59 years are 2.5 times higher (95% confidence interval 1.5–4.1). Morphological verification of the Operative Link for Gastritis Assessment diagnosis is not carried out in clinical practice in most cases. However, this method remains the most reliable method for timely verification of chronic atrophic gastritis, including chronic atrophic gastritis of mixed origin (autoimmune gastritis and Helicobacter pylori-associated gastritis), especially in the case of a seronegative variant of autoimmune gastritis. Also, in addition to the heterogeneity of epidemiological data on chronic atrophic gastritis, there is disagreement about how to confirm its etiology as well as about the correlation of serological markers of atrophy and histological stage.
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慢性萎缩性胃炎:诊断重点
目前,慢性萎缩性胃炎是胃癌发病的一个危险因素。俄罗斯和世界上有关慢性萎缩性胃炎发病率的数据都很有限。在圣彼得堡 21 至 81 岁的成年人口中,经组织学验证的慢性萎缩性胃炎发病率为 5.3%。此外,60 岁以上人群患慢性萎缩性胃炎的几率是 45-59 岁人群的 2.5 倍(95% 置信区间为 1.5-4.1)。在临床实践中,大多数情况下并不对胃炎评估诊断的手术环节进行形态学验证。然而,这种方法仍然是及时验证慢性萎缩性胃炎(包括混合源性慢性萎缩性胃炎(自身免疫性胃炎和幽门螺杆菌相关性胃炎))的最可靠方法,尤其是在自身免疫性胃炎血清阴性变异的情况下。此外,除了有关慢性萎缩性胃炎的流行病学数据的异质性之外,在如何确认其病因以及萎缩的血清学标志物与组织学阶段的相关性方面也存在分歧。
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