Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo, Japan.
Department of Gastroenterology and Hepatology, International University of Health and Welfare Narita Hospital, Chiba, Japan.
Scand J Gastroenterol. 2022 Feb;57(2):143-148. doi: 10.1080/00365521.2021.1994642. Epub 2021 Oct 25.
Autoimmune gastritis (AIG) is histologically classified into three phases according to the severity of oxyntic mucosal atrophy: early, florid, and end phases. This study aimed to clarify the relationship between the AIG phase and the anti-parietal cell antibody titer.
Patients who underwent upper gastrointestinal endoscopy were retrospectively reviewed in this study. We enrolled patients who were histologically diagnosed with AIG and serologically tested for anti-parietal cell antibody (APCA). AIG patients were classified into three groups: early, florid, and end phase groups. Clinical characteristics, including APCA titers, were compared among these three groups.
A total of 44 AIG patients were enrolled. There were two patients in the early phase, 11 in the florid phase, and 31 in the end phase. APCA-positive rates were 100% in the early phase, 90.9% in the florid phase, and 90.3% in the end phase. The mean APCA titer was 480 U in the early phase, 220 U in the florid phase, and 150 U in the end phase. There was a stepwise decrease in the APCA titer from the early phase to the end phase. The mean APCA titer for the end phase was significantly lower than that of the early phase or florid phase. Additionally, there was a stepwise decrease in serum gastrin levels from the early phase to the end phase.
AIG progresses from the early phase to the end phase, and the APCA titer shows a decrease. The negativity of APCA could occur, especially in the end phase.
根据胃黏膜萎缩的严重程度，自身免疫性胃炎（AIG）可在组织学上分为三个阶段：早期、活跃期和终末期。本研究旨在阐明 AIG 阶段与壁细胞抗体滴度之间的关系。
本研究回顾性分析了接受上消化道内镜检查的患者。我们纳入了组织学诊断为 AIG 且血清学检测壁细胞抗体（APCA）的患者。将 AIG 患者分为三组：早期、活跃期和终末期组。比较三组患者的临床特征，包括 APCA 滴度。
共纳入 44 例 AIG 患者，其中早期 2 例，活跃期 11 例，终末期 31 例。早期、活跃期和终末期 APCA 阳性率分别为 100%、90.9%和 90.3%。早期 APCA 滴度均值为 480 U，活跃期为 220 U，终末期为 150 U，呈逐渐降低趋势。终末期 APCA 滴度明显低于早期或活跃期，差异有统计学意义。此外，血清胃泌素水平也呈逐渐降低趋势。
AIG 从早期进展到终末期，APCA 滴度下降。APCA 可能会转为阴性，尤其是在终末期。
