自身免疫性萎缩性胃炎是一种免疫介导的疾病,导致专门的产酸胃壁细胞的自身免疫破坏。因此,在自身免疫性萎缩性胃炎中,胃酸分泌不可逆受损,而由此产生的低盐酸会导致主要的临床表现,并且是有联系的,直接或间接,这种疾病的长期肿瘤性并发症。在过去的几年里,自身免疫性萎缩性胃炎引起了人们越来越多的兴趣,从而获得了有关该疾病不同方面的新知识。尽管可靠的血清学生物标志物是可用的,并且胃肠内窥镜检查技术已经有了实质性的发展,自身免疫性萎缩性胃炎的诊断仍然受到相当大的延迟的影响,并且依赖于胃活检的组织病理学评估。诊断延迟的原因之一是引起临床怀疑的自身免疫性萎缩性胃炎的临床表现非常不同,范围从血液学到神经-精神病,再到胃肠道,很少见到妇产科症状或体征。因此,患有自身免疫性萎缩性胃炎的患者通常会向胃肠病学家以外的其他医学专业的医生寻求建议,因此强调需要在广泛的医学和科学界提高对这种疾病的认识。
Autoimmune atrophic gastritis is an immune-mediated disease resulting in autoimmune destruction of the specialized acid-producing gastric parietal cells. As a consequence, in autoimmune atrophic gastritis, gastric acid secretion is irreversibly impaired, and the resulting hypochlorhydria leads to the main clinical manifestations and is linked, directly or indirectly, to the long-term neoplastic complications of this disease. In the last few years, autoimmune atrophic gastritis has gained growing interest leading to the acquisition of new knowledge on different aspects of this disorder. Although reliable serological biomarkers are available and gastrointestinal endoscopy techniques have substantially evolved, the diagnosis of autoimmune atrophic gastritis is still affected by a considerable delay and relies on histopathological assessment of gastric biopsies. One of the reasons for the diagnostic delay is that the clinical presentations of autoimmune atrophic gastritis giving rise to clinical suspicion are very different, ranging from hematological to neurological-psychiatric up to gastrointestinal and less commonly to gynecological-obstetric symptoms or signs. Therefore, patients with autoimmune atrophic gastritis often seek advice from physicians of other medical specialties than gastroenterologists, thus underlining the need for increased awareness of this disease in a broad medical and scientific community.