Kitamura Shinji, Muguruma Naoki, Okamoto Koichi, Kagemoto Kaizo, Kida Yoshifumi, Mitsui Yasuhiro, Ueda Hiroyuki, Kawaguchi Tomoyuki, Miyamoto Hiroshi, Sato Yasushi, Aoki Rika, Shunto Joji, Bando Yoshimi, Takayama Tetsuji
Department of Gastroenterology and Oncology Tokushima University Graduate School of Biomedical Sciences Tokushima Japan.
Tokushima Health Screening Center Tokushima Japan.
JGH Open. 2021 Sep 16;5(10):1210-1215. doi: 10.1002/jgh3.12656. eCollection 2021 Oct.
Autoimmune gastritis is known to be associated with neoplastic lesions but the relationship between autoimmunity and tumorigenesis have not been sufficiently clarified. The aim of this study is to assess the clinicopathological characteristics of gastric cancer cases associated with autoimmune gastritis.
A total of 24 patients diagnosed as early gastric cancer with autoimmune gastritis were registered. Chart reviews with the data including age, gender, state of infection, comorbidity, and concomitant gastric diseases were conducted. As for the characteristics of gastric cancer, location, size, morphological type, histopathology, invasion depth, and the presence of metachronous or simultaneous lesion were assessed. These data from autoimmune gastritis group were compared with those from 301 patients of early gastric cancer as a control group.
The gastric cancer associated with autoimmune gastritis was located in the upper, middle, and lower parts in 28.1%, 53.1%, and 18.8%, respectively. The morphological types are as follows: 0-I, 9.4%; 0-IIa, 28.1%; 0-IIb, 15.6%; 0-IIc, 46.9%; and 0-III, 0.0%. The mean tumor size was 21.8 mm. While 90.6% were confined to the mucosa, 9.4% showed submucosal invasion. The histological classifications are as follows: tub1, 50.0%; tub2, 15.6%; pap, 21.9%; sig, 9.4%; and por, 3.1%. More numbers of female, protruded types, larger tumor size, papillary tumor, and that in the upper location were observed in autoimmune gastritis group compared to control group.
Early gastric cancer associated with autoimmune gastritis demonstrated different characteristics from those without autoimmune gastritis including variety of tumor morphologies and histological types with female dominancy.
自身免疫性胃炎已知与肿瘤性病变相关，但自身免疫与肿瘤发生之间的关系尚未得到充分阐明。本研究的目的是评估与自身免疫性胃炎相关的胃癌病例的临床病理特征。
共登记了24例诊断为自身免疫性胃炎伴早期胃癌的患者。对包括年龄、性别、感染状况、合并症和伴随胃部疾病等数据进行病历回顾。至于胃癌的特征，评估其位置、大小、形态类型、组织病理学、浸润深度以及异时性或同时性病变的存在情况。将自身免疫性胃炎组的这些数据与301例早期胃癌患者作为对照组的数据进行比较。
与自身免疫性胃炎相关的胃癌分别位于上、中、下部分的比例为28.1%、53.1%和18.8%。形态类型如下：0-I型，9.4%；0-IIa型，28.1%；0-IIb型，15.6%；0-IIc型，46.9%；0-III型，0.0%。肿瘤平均大小为21.8毫米。虽然90.6%局限于黏膜层，但9.4%显示有黏膜下层浸润。组织学分类如下：管状腺癌1型，50.0%；管状腺癌2型，15.6%；乳头状腺癌，21.9%；印戒细胞癌，9.4%；低分化腺癌，3.1%。与对照组相比，自身免疫性胃炎组观察到更多女性、隆起型、肿瘤较大、乳头状肿瘤以及位于上部的病例。
与自身免疫性胃炎相关的早期胃癌表现出与无自身免疫性胃炎的早期胃癌不同的特征，包括多种肿瘤形态和组织学类型，且以女性为主。
