Fuentes-Valenzuela Esteban, Escribano Cruz Sergio, Parra Villanueva Javier, Calvache Rodríguez Almudena, Gil Díaz Ariadna, López-Martín María Del Carmen, Rubio de la Plaza Itziar, Blanco Santiago, Chivato Martín-Falquina Irene, Rodríguez-Batllori Aran Beatriz, Latorre Martinez Raquel, Castillo Herrera Luis Alonso, Olvera Rafael, Alcalde Rodríguez Daniel, Guzmán López Karina, Bejerano Domínguez Alicia
Gastroenterology , Hospital Universitario Infanta Elena , España.
Gastroenterology, Hospital Universitario Infanta Elena, España.
Rev Esp Enferm Dig. 2025 Aug;117(8):441-446. doi: 10.17235/reed.2025.11101/2025.
There is growing interest in autoimmune gastritis (AIG), particularly regarding its prevalence and natural history.
A retrospective observational study was performed, including all patients with positive parietal cell antibodies who underwent gastroscopy between 2013 and 2023. The first subsequent gastroscopy was defined as follow-up endoscopy and considered for histological comparison. Categorization of histological stages was as follows; stage 0 (potential), stage I (non-atrophic gastritis), stage II (atrophic gastritis) and stage III (dysplasia, neuroendocrine tumor or adenocarcinoma).
A total of 426 patients were included, 316 were female with a median of 54.4 years (IQR 45.3-63.2). During this period, a total of 26798 patients underwent at least one upper endoscopy, so the prevalence of AIG was 1.6% (95% CI 1.4-1.7%). Histologically, 105 patients were classified as potential AIG (24.7%), 99 patients as stage I (23,2%), 215 patients as stage II (50.5%) and 7 patients as stage III (1.6%). 153 patients had a follow-up endoscopy. A significant increase of advanced stage disease was observed at follow-up (difference 18.7% 95% CI 7.6%-29%; p=0.001) and a decrease of potential GAI (difference 20.2% 95% CI 11.8% -28.7%; p<0.001). At baseline, 39 patients exhibited hyperplastic polyps (9.2%), 8 patients fundic gland polyps (1.9%), 3 adenomas with low-grade dysplasia (0.7%) and 3 patients presented G1 neuroendocrine tumors (0.7%). Only one patient (0.2%) was diagnosed with signet-ring cell gastric carcinoma.
AIG has a low prevalence among patients undergoing gastroscopy. Biopsies in patients with positive parietal cell antibodies showed that around half of the population exhibit significant atrophy and a notable progressive disease.
自身免疫性胃炎（AIG）越来越受到关注，尤其是其患病率和自然史。
进行了一项回顾性观察研究，纳入了2013年至2023年间所有接受胃镜检查且壁细胞抗体呈阳性的患者。首次后续胃镜检查被定义为随访内镜检查，并用于组织学比较。组织学阶段分类如下：0期（潜在期）、I期（非萎缩性胃炎）、II期（萎缩性胃炎）和III期（发育异常、神经内分泌肿瘤或腺癌）。
共纳入426例患者，其中316例为女性，中位年龄54.4岁（四分位间距45.3 - 63.2岁）。在此期间，共有26798例患者接受了至少一次上消化道内镜检查，因此AIG的患病率为1.6%（95%置信区间1.4 - 1.7%）。组织学上，105例患者被分类为潜在性AIG（24.7%），99例为I期（23.2%），215例为II期（50.5%），7例为III期（1.6%）。153例患者接受了随访内镜检查。随访时观察到晚期疾病显著增加（差异18.7%，95%置信区间7.6% - 29%；p = 0.001），潜在性GAI减少（差异20.2%，95%置信区间11.8% - 28.7%；p < 0.001）。基线时，39例患者表现为增生性息肉（9.2%），8例为胃底腺息肉（1.9%），3例为低级别发育异常腺瘤（0.7%），3例患者表现为G1神经内分泌肿瘤（0.7%）。仅1例患者（0.2%）被诊断为印戒细胞胃癌。
AIG在接受胃镜检查的患者中患病率较低。壁细胞抗体呈阳性患者的活检显示，约一半人群存在显著萎缩和明显的进展性疾病。
