自身免疫性胃炎11例病理临床特征分析  

The Pathological and Clinical Characteristics of 11 Cases of Autoimmune Gastritis

作　　者：王军 孟宇宏 温宗华 付先利 刘振宇 WANG Jun;MENG Yuhong;WEN Zonghua;FU Xianli;LIU Zhenyu(Department of Pathology,Shenzhen University General Hospital,Shenzhen,518071,China;Department of Gastroenterology,Shenzhen University General Hospital,Shenzhen,518071,China)

机构地区：[1]深圳大学总医院病理科,深圳518071 [2]深圳大学总医院消化内科,深圳518071

出　　处：《标记免疫分析与临床》2024年第7期1232-1235,1247,共5页Labeled Immunoassays and Clinical Medicine

基　　金：国家自然科学基金青年科学基金项目(编号:81800586)。

摘　　要：目的探讨自身免疫性胃炎(autoimmune gastritis,AIG)的临床、病理特点,加强相互联系,提高诊断的时效性和准确性。方法收集11例AIG患者临床、病理资料,结合文献进行分析。结果女性8例,男性3例,年龄31~78岁,中位年龄53岁;临床表现为非特异性症状,3例合并幽门螺杆菌感染;萎缩最常见于胃体,其次为胃底;4例贫血症状患者,3例行病理检查,均合并有神经内分泌细胞增生性病变;1例患者出现贫血症状到最终在病理医师指导下确诊为AIG耗时3年。结论AIG患者不同临床阶段临床症状、内镜及病理学表现不尽相同,容易漏诊;建议对疑有胃底、胃体黏膜萎缩病例常规进行活检,尤其是胃体黏膜活检对AIG的诊断具有重要价值;贫血伴神经内分泌细胞增生性病变及萎缩伴神经内分泌细胞增生性病变高度提示AIG可能。Objective To investigate the clinical and pathological features of autoimmune gastritis,and to strengthen the interrelation,so as to further improve the timeliness and accuracy of diagnosis.Methods The clinical and pathological features of 11 AIG patients of our hospital were collected and analyzed according to previous literatures.Results The selected patients included 8 females and 3 males,ranging in age from 31 to 78 years,with a median age of 53 years.The clinical manifestations were nonspecific and there were 3 cases with Helicobacter Pylori infection;The atrophy was most common in the body of stomach,followed by the fundus of stomach;4 cases were accompanied by anemia,and 3 of them were accompanied by neuroendocrine cell proliferative lesions;It took 3 years for 1 patient to develop anemia symptoms and to be diagnosed as AIG under the guidance of a pathologist.Conclusion The clinical symptoms,endoscopic and pathological manifestations of AIG patients are different individually,and the endoscopic manifestations are not specific,which can easily cause miss diagnosis.It is recommended to perform routine biopsy in suspected cases of fundus and body mucosa atrophy.In particular,gastric body mucosal biopsy is of great value in the diagnosis of AIG.Anemia with neuroendocrine cell proliferative lesions and atrophy with neuroendocrine cell proliferative lesions are highly suggestive of AIG diagnosis.

关 键 词：自身免疫性胃炎 病理 临床特征 萎缩 抗壁细胞抗体 

分 类 号：R573.3[医药卫生—消化系统]