Annibale Bruno, Lahner Edith, Negrini Riccardo, Baccini Flavia, Bordi Cesare, Monarca Bruno, Delle Fave Gianfranco
Department of Digestive and Liver Disease, University La Sapienza, Ospedale Sant'Andrea, Via di Grottarossa 1035, Roma 00189, Italy.
World J Gastroenterol. 2005 Sep 14;11(34):5351-7. doi: 10.3748/wjg.v11.i34.5351.
To investigate the possible relationships between gastric autoimmune phenomena and clinical presentations of this disorder, in consecutive atrophic body gastritis patients.
A total of 140 atrophic body gastritis patients, diagnosed as consecutive outpatients presenting with macrocytic or iron deficiency anemia, or longstanding dyspepsia underwent gastroscopy with antral and body biopsies, assay of intrinsic factor, parietal cells and Helicobacter pylori (H pylori) antibodies. Gastritis was assessed according to Sydney System.
Parietal cell antibodies were equally distributed in all clinical presentations, whereas the positivity of intrinsic factor antibodies (49/140, 35%) was significantly higher in pernicious anemia patients (49.2%) than in iron deficiency (21.1%) and dyspeptic patients (27.8%). No specific pattern of autoantibodies was related to the clinical presentations of atrophic body gastritis. A positive correlation was obtained between the body atrophy score and the intrinsic factor antibody levels (r = 0.2216, P = 0.0085). Associated autoimmune diseases were present in 25/140 (17.9%) patients, but the prevalence of autoimmune diseases was comparable, irrespective of the clinical presentations.
The so-called hallmarks of gastric autoimmunity, particularly in intrinsic factor antibody cannot be usefully employed in defining an autoimmune pattern in the clinical presentations of ABG.
在连续性萎缩性胃体炎患者中,研究胃部自身免疫现象与该疾病临床表现之间的可能关系。
总共140例萎缩性胃体炎患者,这些患者作为连续性门诊患者,表现为大细胞性贫血或缺铁性贫血,或长期消化不良,均接受了胃镜检查及胃窦和胃体活检、内因子、壁细胞和幽门螺杆菌(Hp)抗体检测。根据悉尼系统评估胃炎情况。
壁细胞抗体在所有临床表现中分布均匀,而内因子抗体阳性率(49/140,35%)在恶性贫血患者(49.2%)中显著高于缺铁性贫血患者(21.1%)和消化不良患者(27.8%)。自身抗体的特定模式与萎缩性胃体炎的临床表现无关。胃体萎缩评分与内因子抗体水平之间呈正相关(r = 0.2216,P = 0.0085)。140例患者中有25例(17.9%)存在相关自身免疫性疾病,但无论临床表现如何,自身免疫性疾病的患病率相当。
所谓的胃部自身免疫特征,尤其是内因子抗体,在定义萎缩性胃体炎临床表现中的自身免疫模式时并无实际用途。