Antral mucosa healing at long-term follow-up in patients with corpus atrophic gastritis and concomitant antral gastritis may mimic autoimmune gastritis.

IF 4 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Digestive and Liver Disease Pub Date : 2024-10-08 DOI:10.1016/j.dld.2024.09.017
Ludovica Dottori, Carla Palumbo, Emanuele Dilaghi, Giulia Pivetta, Irene Ligato, Gianluca Esposito, Emanuela Pilozzi, Bruno Annibale, Edith Lahner
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Abstract

Background and aim: Corpus atrophic gastritis (CAG) is defined as autoimmune when the antrum is spared, representing this element a crucial diagnostic criterium of autoimmune gastritis. In contrast, CAG with concomitant antral gastritis (AG), atrophic or non-atrophic, is generally attributed to H. pylori infection. During the natural history of CAG, possible antrum healing has been supposed. The current study aimed to assess the antral mucosa histopathological changes at long-term follow-up (FU) with respect to baseline in patients with CAG and concomitant atrophic or non-atrophic gastritis AG.

Methods: Retrospective study on 130 patients with histologically diagnosed CAG with atrophic or non-atrophic AG. Mean FU gastroscopy was at 40.6 (range 4-192) months. Patients with confirmed CAG (n = 117; median age 66, range 20-87 years; 67.5 % F) were finally included. At baseline, 47 (40.2 %) had non-atrophic and 70 (59.8 %) atrophic AG. Helicobacter pylori (Hp) infection was present at histology in 27.3 % of patients, all treated.

Results: At FU, 30/117(25.6 %) patients showed a complete antral healing; 11/29(37.9 %) were Hp positive at baseline, cured in all but one. Atrophic AG regressed in 16/70(22.8 %) patients. Both, antral healing and regression of antral AG, were found to be similar in Hp-cured and not-cured/ naïve-negatives patients (p > 0.05).

Conclusion: In a subset of CAG patients, AG may regress at long-term FU irrespective of Hp cure, thus mimicking autoimmune atrophic gastritis and raising concerns about its current histopathological diagnostic criteria.

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萎缩性胃体炎和并发前胃炎患者在长期随访中的前胃黏膜愈合可能模仿自身免疫性胃炎。
背景和目的:当胃窦没有萎缩时,胃体萎缩性胃炎(CAG)被定义为自身免疫性胃炎,这是自身免疫性胃炎的一个重要诊断标准。相比之下,伴有萎缩性或非萎缩性前胃炎(AG)的 CAG 通常归因于幽门螺杆菌感染。在CAG的自然病史中,可能存在胃窦愈合的假说。本研究旨在评估CAG和同时患有萎缩性或非萎缩性胃炎的AG患者在长期随访(FU)期间窦前粘膜组织病理学与基线相比的变化:对130例经组织学诊断为CAG并伴有萎缩性或非萎缩性AG的患者进行回顾性研究。平均FU胃镜检查时间为40.6个月(4-192个月)。最终纳入确诊的 CAG 患者(n = 117;中位年龄 66 岁,范围 20-87 岁;67.5% 女性)。基线时,47 例(40.2%)为非萎缩性 AG,70 例(59.8%)为萎缩性 AG。在组织学检查中,27.3%的患者存在幽门螺杆菌(Hp)感染,所有患者均接受过治疗:治疗后,30/117(25.6%)名患者的窦口完全愈合;11/29(37.9%)名患者的基线幽门螺杆菌感染呈阳性,除一名患者外,其余患者均已治愈。16/70(22.8%)名患者的萎缩性 AG 恢复。Hp治愈和未治愈/天真阴性患者的前列腺愈合和前列腺AG消退情况相似(P > 0.05):结论:在一部分CAG患者中,无论Hp是否治愈,AG都可能在长期治疗后消退,从而模仿自身免疫性萎缩性胃炎,并引起了对其当前组织病理学诊断标准的关注。
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来源期刊
Digestive and Liver Disease
Digestive and Liver Disease 医学-胃肠肝病学
CiteScore
6.10
自引率
2.20%
发文量
632
审稿时长
19 days
期刊介绍: Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.
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