韩国胃肿瘤患者的自身免疫性胃炎:临床病理相关性和诊断性组织学特征

IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Gut and Liver Pub Date : 2024-11-07 DOI:10.5009/gnl240223
Soomin Ahn, Tae-Se Kim, Ryoji Kushima, Jun Haeng Lee, Kyoung-Mee Kim
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引用次数: 0

摘要

背景/目的:自身免疫性胃炎(AIG)是一种以胃体为主的萎缩性胃炎,患者的抗顶叶细胞抗体(APCA)和/或抗内膜因子抗体呈阳性。AIG患者罹患胃癌的风险尚不明确,也缺乏AIG在胃癌患者中发生频率的可靠数据:我们纳入了 624 名韩国胃肿瘤患者(612 名胃癌患者和 12 名神经内分泌肿瘤患者),这些患者均有 APCA 结果,并可进行 AIG 评估。对 APCA 结果呈阳性的患者进行内镜检查和组织学检查,以诊断 AIG:在 624 名患者中,有 37 人(5.9%)的 APCA 检测结果呈阳性,最终有 11 人(1.8%)符合 AIG 诊断标准(5 人同时有内窥镜检查和组织学检查结果,4 人仅有内窥镜检查结果,2 人仅有组织学检查结果)。胃癌患者中的AIG发生率为1.3%(8/612),神经内分泌肿瘤患者中的AIG发生率为25.0%(3/12)。在 11 例 AIG 患者中,有 6 例(54.5%)血清幽门螺杆菌抗体呈阳性,他们都患有胃癌。在组织学上,3 名患者表现为纯 AIG,4 名患者表现为并发 AIG 和幽门螺杆菌胃炎,4 名患者的 AIG 结果不明确。有 AIG 的胃癌患者胃蛋白酶原 (PG) I 水平和 PG I/II 比值明显低于无 AIG 的胃癌患者(分别为 p=0.042 和 p=0.016):结论:与神经内分泌肿瘤患者相比,AIG在胃癌患者中的发生率非常低。结论:与神经内分泌肿瘤患者相比,AIG 在胃癌患者中的发病率非常低,相反,在患有 AIG 的胃癌患者中,同时患有 AIG 和幽门螺杆菌胃炎的情况很常见。
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Autoimmune Gastritis in Korean Patients with Gastric Tumors: Clinicopathologic Correlations and Diagnostic Histological Features.

Background/aims: Autoimmune gastritis (AIG) is a corpus-dominant atrophic gastritis in which patients are positive for antiparietal cell antibody (APCA) and/or anti-intrinsic factor antibody. The risk of developing gastric cancer in patients with AIG remains unclear, and reliable frequency data of AIG in patients with gastric cancer are lacking.

Methods: We included 624 Korean patients with gastric tumors (612 gastric cancers and 12 neuroendocrine tumors) who had APCA results and were available for AIG evaluation. In patients with positive APCA results, endoscopy and histology findings were reviewed to diagnose AIG.

Results: Of the 624 patients, 37 (5.9%) tested positive for APCA, and ultimately, 11 (1.8%) met the diagnostic criteria for AIG (5 both endoscopy and histology findings, 4 endoscopy-only findings, 2 histology-only findings). The frequency of AIG in patients with gastric cancer was 1.3% (8/612), and that in patients with neuroendocrine tumors was 25.0% (3/12). Of the 11 patients with AIG, serum Helicobacter pylori antibody was positive in six patients (54.5%), all of whom had gastric cancer. Histologically, three patients showed pure AIG, four patients exhibited concurrent AIG and H. pylori gastritis, and the findings for four were indefinite for AIG. The pepsinogen (PG) I levels and PG I/II ratio were significantly lower in patients with gastric cancer with AIG than in patients with gastric cancer without AIG (p=0.042 and p=0.016, respectively).

Conclusions: The frequency of AIG in gastric cancer patients was very low compared to that in patients with neuroendocrine tumors. Rather, concurrent AIG and H. pylori gastritis was common in patients with AIG with gastric cancer.

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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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