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
王军 1孟宇宏 1温宗华 1付先利 1刘振宇2
作者信息
- 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
- 折叠
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.
Abstract
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Key words
Autoimmune gastritis/Pathology/Clinical features/Atrophy/Anti-parietal cell anti-body引用本文复制引用
基金项目
国家自然科学基金青年科学基金(81800586)
出版年
2024
NETL
NSTL
万方数据