Kotera Tohru, Ayaki Maki, Sumi Naoki, Aoki Rika, Mabe Katsuhiro, Inoue Kazuhiko, Manabe Noriaki, Kamada Tomoari, Kushima Ryoji, Haruma Ken
Department of Medical Examination, Uji Tokushukai Medical Center, Uji, Japan.
Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
Endosc Int Open. 2024 Mar 7;12(3):E332-E338. doi: 10.1055/a-2215-3284. eCollection 2024 Mar.
Until recently, autoimmune gastritis (AIG) was usually diagnosed at late stages based on typical endoscopic findings, including corpus-dominant advanced atrophy. Early-stage AIG prior to complete gastric atrophy had rarely been diagnosed due to a lack of knowledge about its endoscopic characteristics. The present study sought to identify the endoscopic characteristics of early-stage AIG, enabling its early diagnosis. The clinical and endoscopic findings of 12 patients diagnosed with early-stage AIG between 2016 and 2021 were retrospectively evaluated. Patients were included if they were: (1) positive for serum anti-parietal cell antibody; (2) diagnosed with histological early-stage AIG; and (3) endoscopically positive for folds on the greater curvature of the gastric corpus. Two characteristic endoscopic findings of early-stage AIG were identified: longitudinal alignment of pseudopolyps (i.e., a bamboo joint-like appearance) and swelling of gastric areas with erythema (i.e., a salmon roe-like appearance). Endoscopic findings characteristic of early-stage AIG include a bamboo joint-like appearance and a salmon roe-like appearance. Studies in large numbers of patients with long-term follow-up are needed to confirm these findings.
直到最近,自身免疫性胃炎(AIG)通常是根据典型的内镜检查结果在晚期才得以诊断,这些结果包括以胃体为主的重度萎缩。由于对其内镜特征缺乏了解,在完全胃萎缩之前的早期AIG很少被诊断出来。本研究旨在确定早期AIG的内镜特征,以实现其早期诊断。对2016年至2021年间诊断为早期AIG的12例患者的临床和内镜检查结果进行了回顾性评估。纳入的患者需满足以下条件:(1)血清抗壁细胞抗体呈阳性;(2)经组织学诊断为早期AIG;(3)内镜检查显示胃体大弯侧皱襞阳性。确定了早期AIG的两个特征性内镜检查结果:假息肉纵向排列(即竹节样外观)和胃区伴有红斑的肿胀(即鲑鱼籽样外观)。早期AIG的特征性内镜检查结果包括竹节样外观和鲑鱼籽样外观。需要对大量患者进行长期随访研究以证实这些结果。