Ahn Soomin, Kim Tae-Se, Kushima Ryoji, Lee Jun Haeng, Kim Kyoung-Mee
Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Gut Liver. 2025 Mar 15;19(2):177-188. doi: 10.5009/gnl240223. Epub 2024 Nov 7.
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.
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.
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 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 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).
The frequency of AIG in gastric cancer patients was very low compared to that in patients with neuroendocrine tumors. Rather, concurrent AIG and gastritis was common in patients with AIG with gastric cancer.
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，患者抗壁细胞抗体（APCA）和/或抗内因子抗体呈阳性。AIG患者发生胃癌的风险尚不清楚，且缺乏胃癌患者中AIG的可靠发生率数据。
我们纳入了624例有APCA检测结果且可进行AIG评估的韩国胃肿瘤患者（612例胃癌和12例神经内分泌肿瘤）。APCA结果呈阳性的患者，对其内镜检查和组织学检查结果进行回顾以诊断AIG。
624例患者中，37例（5.9%）APCA检测呈阳性，最终11例（1.8%）符合AIG诊断标准（5例内镜和组织学检查结果均符合，4例仅内镜检查结果符合，2例仅组织学检查结果符合）。胃癌患者中AIG的发生率为1.3%（8/612），神经内分泌肿瘤患者中AIG的发生率为25.0%（3/12）。11例AIG患者中，6例（54.5%）血清抗体呈阳性，所有这些患者均患有胃癌。组织学上，3例表现为单纯AIG，4例表现为AIG与胃炎并存，4例结果不明确。伴有AIG的胃癌患者的胃蛋白酶原（PG）I水平和PG I/II比值显著低于不伴有AIG的胃癌患者（分别为p = 0.042和p = 0.016）。
与神经内分泌肿瘤患者相比，胃癌患者中AIG的发生率非常低。相反，伴有胃癌的AIG患者中AIG与胃炎并存很常见。
