自身免疫性胃炎的鉴别特征取决于幽门螺杆菌感染或抗顶叶细胞抗体阳性:意大利自身免疫性胃炎网络研究小组(ARIOSO)的研究结果。

IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
American Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI:10.14309/ajg.0000000000002948
Marco Vincenzo Lenti, Emanuela Miceli, Edith Lahner, Gabriele Natalello, Sara Massironi, Annalisa Schiepatti, Fabiana Zingone, Valentina Sciola, Roberta Elisa Rossi, Renato Cannizzaro, Elena Maria De Giorgi, Virginia Gregorio, Erica Fazzino, Antonella Gentile, Clarissa Petrucci, Emanuele Dilaghi, Giulia Pivetta, Alessandro Vanoli, Ombretta Luinetti, Marco Paulli, Andrea Anderloni, Maurizio Vecchi, Federico Biagi, Alessandro Repici, Edoardo Vincenzo Savarino, Shamim Joudaki, Mariangela Delliponti, Alessandra Pasini, Federica Facciotti, Fabio Farinati, Mario Milco D'Elios, Chiara Della Bella, Bruno Annibale, Catherine Klersy, Gino Roberto Corazza, Antonio Di Sabatino
{"title":"自身免疫性胃炎的鉴别特征取决于幽门螺杆菌感染或抗顶叶细胞抗体阳性:意大利自身免疫性胃炎网络研究小组(ARIOSO)的研究结果。","authors":"Marco Vincenzo Lenti, Emanuela Miceli, Edith Lahner, Gabriele Natalello, Sara Massironi, Annalisa Schiepatti, Fabiana Zingone, Valentina Sciola, Roberta Elisa Rossi, Renato Cannizzaro, Elena Maria De Giorgi, Virginia Gregorio, Erica Fazzino, Antonella Gentile, Clarissa Petrucci, Emanuele Dilaghi, Giulia Pivetta, Alessandro Vanoli, Ombretta Luinetti, Marco Paulli, Andrea Anderloni, Maurizio Vecchi, Federico Biagi, Alessandro Repici, Edoardo Vincenzo Savarino, Shamim Joudaki, Mariangela Delliponti, Alessandra Pasini, Federica Facciotti, Fabio Farinati, Mario Milco D'Elios, Chiara Della Bella, Bruno Annibale, Catherine Klersy, Gino Roberto Corazza, Antonio Di Sabatino","doi":"10.14309/ajg.0000000000002948","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>To describe the clinical features and the risk of developing gastric tumors in patients with autoimmune gastritis (AIG).</p><p><strong>Methods: </strong>This was a retrospective, longitudinal, multicenter study conducted at 8 Italian tertiary referral centers. We retrieved clinical data from all histologically proven patients with AIG. Differences between Helicobacter pylori -exposed vs H. pylori -naive and anti-parietal cell antibody (PCA)-positive vs PCA-negative patients were investigated. The rate of gastric adenocarcinoma and type 1 gastric neuroendocrine neoplasm (gNEN) was assessed. A multivariable model for factors associated with gNEN was fitted.</p><p><strong>Results: </strong>A total of 1,598 patients with AIG (median age 58 years, interquartile range 46-68; F:M ratio 2.7:1) were included. H. pylori -naive patients were more likely to have a first-degree family history of AIG (14.7% vs 8.9%; P = 0.012), type 1 diabetes mellitus (4.9% vs 2.3%; P = 0.025), and pernicious anemia (30.9% vs 21.1%; P = 0.003). PCA-positive patients had significantly more associated autoimmune diseases (59.0% vs 42.9%; P < 0.001) and were more likely to have been diagnosed by a case-finding strategy (15.3% vs 2.6%; P < 0.001). Overall, 15 cases (0.9%) of gastric adenocarcinoma and 153 cases (9.6%) of gNEN occurred, with a global rate of 0.12 (95% confidence interval [CI] 0.07-0.20) and 1.22 (95% CI 1.03-1.42) per 100 person/year, respectively. Having a vitamin B12/iron deficiency manifestation at AIG diagnosis was associated with a 16.44 (95% CI 9.94-27.20 P < 0.001) hazard ratio of gNEN.</p><p><strong>Discussion: </strong>The \"pure\" AIG pattern has typical features of an autoimmune disease and seems to be unrelated to H. pylori . In a tertiary referral setting, the risk of developing overt gastric adenocarcinoma is low, while patients with vitamin B12 deficiency complications at onset may benefit from a more intense endoscopic follow-up for early gNEN detection.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":"2408-2417"},"PeriodicalIF":8.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Distinguishing Features of Autoimmune Gastritis Depending on Previous Helicobacter pylori Infection or Positivity to Anti-Parietal Cell Antibodies: Results From the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO).\",\"authors\":\"Marco Vincenzo Lenti, Emanuela Miceli, Edith Lahner, Gabriele Natalello, Sara Massironi, Annalisa Schiepatti, Fabiana Zingone, Valentina Sciola, Roberta Elisa Rossi, Renato Cannizzaro, Elena Maria De Giorgi, Virginia Gregorio, Erica Fazzino, Antonella Gentile, Clarissa Petrucci, Emanuele Dilaghi, Giulia Pivetta, Alessandro Vanoli, Ombretta Luinetti, Marco Paulli, Andrea Anderloni, Maurizio Vecchi, Federico Biagi, Alessandro Repici, Edoardo Vincenzo Savarino, Shamim Joudaki, Mariangela Delliponti, Alessandra Pasini, Federica Facciotti, Fabio Farinati, Mario Milco D'Elios, Chiara Della Bella, Bruno Annibale, Catherine Klersy, Gino Roberto Corazza, Antonio Di Sabatino\",\"doi\":\"10.14309/ajg.0000000000002948\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>To describe the clinical features and the risk of developing gastric tumors in patients with autoimmune gastritis (AIG).</p><p><strong>Methods: </strong>This was a retrospective, longitudinal, multicenter study conducted at 8 Italian tertiary referral centers. We retrieved clinical data from all histologically proven patients with AIG. Differences between Helicobacter pylori -exposed vs H. pylori -naive and anti-parietal cell antibody (PCA)-positive vs PCA-negative patients were investigated. The rate of gastric adenocarcinoma and type 1 gastric neuroendocrine neoplasm (gNEN) was assessed. A multivariable model for factors associated with gNEN was fitted.</p><p><strong>Results: </strong>A total of 1,598 patients with AIG (median age 58 years, interquartile range 46-68; F:M ratio 2.7:1) were included. H. pylori -naive patients were more likely to have a first-degree family history of AIG (14.7% vs 8.9%; P = 0.012), type 1 diabetes mellitus (4.9% vs 2.3%; P = 0.025), and pernicious anemia (30.9% vs 21.1%; P = 0.003). PCA-positive patients had significantly more associated autoimmune diseases (59.0% vs 42.9%; P < 0.001) and were more likely to have been diagnosed by a case-finding strategy (15.3% vs 2.6%; P < 0.001). Overall, 15 cases (0.9%) of gastric adenocarcinoma and 153 cases (9.6%) of gNEN occurred, with a global rate of 0.12 (95% confidence interval [CI] 0.07-0.20) and 1.22 (95% CI 1.03-1.42) per 100 person/year, respectively. Having a vitamin B12/iron deficiency manifestation at AIG diagnosis was associated with a 16.44 (95% CI 9.94-27.20 P < 0.001) hazard ratio of gNEN.</p><p><strong>Discussion: </strong>The \\\"pure\\\" AIG pattern has typical features of an autoimmune disease and seems to be unrelated to H. pylori . In a tertiary referral setting, the risk of developing overt gastric adenocarcinoma is low, while patients with vitamin B12 deficiency complications at onset may benefit from a more intense endoscopic follow-up for early gNEN detection.</p>\",\"PeriodicalId\":7608,\"journal\":{\"name\":\"American Journal of Gastroenterology\",\"volume\":\" \",\"pages\":\"2408-2417\"},\"PeriodicalIF\":8.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.14309/ajg.0000000000002948\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14309/ajg.0000000000002948","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:描述自身免疫性胃炎(AIG)患者的临床特征和罹患胃肿瘤的风险:描述自身免疫性胃炎(AIG)患者的临床特征和罹患胃肿瘤的风险:这是一项回顾性、纵向、多中心研究,在意大利八家三级转诊中心进行。我们检索了所有经组织学证实的自身免疫性胃炎(AIG)患者的临床数据。研究调查了幽门螺杆菌暴露与幽门螺杆菌未暴露患者之间的差异,以及抗顶叶细胞抗体(PCA)阳性与PCA阴性患者之间的差异。评估了胃腺癌和1型胃神经内分泌肿瘤(gNEN)的发病率。结果共纳入 1598 名 AIG 患者(中位年龄 58 岁,IQR 46-68;男女比例 2.7:1)。幽门螺杆菌阴性患者更可能有 AIG 一级家族史(14.7% 对 8.9%;P=0.012)、1 型糖尿病(4.9% 对 2.3%;P=0.025)和恶性贫血(30.9% 对 21.1%;P=0.003)。PCA 阳性患者伴有自身免疫性疾病的比例明显更高(59.0% vs 42.9%;P=0.003):纯 "AIG模式具有自身免疫性疾病的典型特征,似乎与幽门螺杆菌无关。在三级转诊机构中,发生明显胃腺癌的风险较低,而发病时有维生素B12缺乏并发症的患者可能会受益于更密集的内镜随访,以便及早发现胃癌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distinguishing Features of Autoimmune Gastritis Depending on Previous Helicobacter pylori Infection or Positivity to Anti-Parietal Cell Antibodies: Results From the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO).

Introduction: To describe the clinical features and the risk of developing gastric tumors in patients with autoimmune gastritis (AIG).

Methods: This was a retrospective, longitudinal, multicenter study conducted at 8 Italian tertiary referral centers. We retrieved clinical data from all histologically proven patients with AIG. Differences between Helicobacter pylori -exposed vs H. pylori -naive and anti-parietal cell antibody (PCA)-positive vs PCA-negative patients were investigated. The rate of gastric adenocarcinoma and type 1 gastric neuroendocrine neoplasm (gNEN) was assessed. A multivariable model for factors associated with gNEN was fitted.

Results: A total of 1,598 patients with AIG (median age 58 years, interquartile range 46-68; F:M ratio 2.7:1) were included. H. pylori -naive patients were more likely to have a first-degree family history of AIG (14.7% vs 8.9%; P = 0.012), type 1 diabetes mellitus (4.9% vs 2.3%; P = 0.025), and pernicious anemia (30.9% vs 21.1%; P = 0.003). PCA-positive patients had significantly more associated autoimmune diseases (59.0% vs 42.9%; P < 0.001) and were more likely to have been diagnosed by a case-finding strategy (15.3% vs 2.6%; P < 0.001). Overall, 15 cases (0.9%) of gastric adenocarcinoma and 153 cases (9.6%) of gNEN occurred, with a global rate of 0.12 (95% confidence interval [CI] 0.07-0.20) and 1.22 (95% CI 1.03-1.42) per 100 person/year, respectively. Having a vitamin B12/iron deficiency manifestation at AIG diagnosis was associated with a 16.44 (95% CI 9.94-27.20 P < 0.001) hazard ratio of gNEN.

Discussion: The "pure" AIG pattern has typical features of an autoimmune disease and seems to be unrelated to H. pylori . In a tertiary referral setting, the risk of developing overt gastric adenocarcinoma is low, while patients with vitamin B12 deficiency complications at onset may benefit from a more intense endoscopic follow-up for early gNEN detection.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
American Journal of Gastroenterology
American Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
11.40
自引率
5.10%
发文量
458
审稿时长
12 months
期刊介绍: Published on behalf of the American College of Gastroenterology (ACG), The American Journal of Gastroenterology (AJG) stands as the foremost clinical journal in the fields of gastroenterology and hepatology. AJG offers practical and professional support to clinicians addressing the most prevalent gastroenterological disorders in patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信