背景:自身免疫性胃炎(AIG)导致胃泌素(G)水平升高,对胃粘膜提供增殖刺激。
目的:评估意大利6个三级中心AIG患者胃息肉的发生率和特征。
方法:多中心,横断面研究纳入了2000年1月至2023年6月诊断为AIG的患者,这些患者接受了至少一次内窥镜检查.人口统计数据,临床病史,生化概况,系统收集内镜和组织病理学发现。
结果:在612名AIG患者中,中位随访时间为4年,222(36.3%)发展了至少一个胃息肉。其中,在162例患者中发现214例非内分泌病变,包括151名炎症(70.5%),29腺瘤(13.6%),18个胃底腺息肉(8.4%),13例腺癌(6.1%),和一个MALT淋巴瘤。此外,108例患者患有胃神经内分泌肿瘤(gNENs),48例也有非内分泌息肉。年龄较大,胃泌素和嗜铬粒蛋白A水平较高与息肉的发生有关。在有和无病变的患者中,OLGA/OLGIM分期或幽门螺杆菌状态均无差异。
结论:这项大型多中心研究强调了AIG患者胃息肉的大量发生,包括gNENs和腺癌的显著发病率,强调主动内镜监测和组织病理学检查对有效管理的重要性。
BACKGROUND: Autoimmune gastritis (AIG) leads to increased gastrin (G) levels due to hypo-achlorhydria, providing proliferative stimuli on the gastric mucosa.
OBJECTIVE: To evaluate the incidence and characteristics of gastric polyps in AIG patients across six tertiary centers in Italy.
METHODS: A multicentric, cross-sectional study enrolled patients with AIG diagnosed from January 2000 to June 2023, who underwent at least one endoscopy. Data on demographics, clinical history, biochemical profiles, and endoscopic and histopathological findings were systematically collected.
RESULTS: Among 612 AIG patients followed for a median of 4 years, 222 (36.3 %) developed at least one gastric polyp. Of these, 214 were non-endocrine lesions detected in 162 patients, including 151 inflammatory (70.5 %), 29 adenomatous (13.6 %), 18 fundic gland polyps (8.4 %), 13 adenocarcinomas (6.1 %), and one MALT lymphoma. Additionally, 108 patients had gastric neuroendocrine neoplasms (gNENs), with 48 also having non-endocrine polyps. Older age and higher gastrin and chromogranin A levels were associated with polyp occurrence. No differences in OLGA/OLGIM stages or Helicobacter pylori status were noted among patients with and without lesions.
CONCLUSIONS: This large multicentric study underscores the substantial occurrence of gastric polyps in AIG patients, including notable rates of gNENs and adenocarcinomas, emphasizing the importance of proactive endoscopic surveillance and histopathological examination for effective management.