Gastric cancer is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. Autoimmune gastritis (AIG) is characterized by antibody production against the gastric parietal cells, reducing the number of functional parietal cells. It is also associated with an increased susceptibility to gastric neuroendocrine tumors and gastric cancer. Endoscopic resection (ER) is an effective treatment for early gastric cancer; however, metachronous gastric neoplasms (MGN) can develop. This study aimed to evaluate the clinical effect of AIG on the occurrence of MGN after ER for gastric neoplasms. We retrospectively analyzed patients who underwent ER for gastric neoplasms. Patients with multiple lesions, recurrent lesions, or a history of partial gastrectomy were excluded. The presence of AIG was determined using anti-parietal cell antibody (APCA) testing. Follow-up endoscopy and metachronous tumor occurrence rates were compared between the AIG and non-AIG groups. Of the 569 patients, 282 underwent APCA testing and 20 (7.1%) were diagnosed with AIG. The incidence of MGN was significantly higher in the AIG group than in the non-AIG group (45.0% vs. 18.3%); however, the MGN occurrence pattern was similar between the two groups. Multivariate analysis revealed that AIG (HR 3.32, 95% CI 1.55–7.10,p= 0.002) and a higher body mass index (HR 1.16, 95% CI 1.06–1.27,p= 0.002) were independent factors significantly associated with the occurrence of MGN. Patients with AIG have a higher risk of metachronous lesion occurrence after ER for gastric neoplasms. Positive results of APCA testing have independent clinical implications for predicting MGN. Proper monitoring and management are essential for early detection and treatment of recurrent lesions in patients with AIG.
胃癌是全球第五大常见癌症及第三大癌症相关死亡原因。自身免疫性胃炎以产生抗胃壁细胞抗体为特征，导致功能性壁细胞数量减少，并与胃神经内分泌肿瘤及胃癌的易感性增加相关。内镜切除术是早期胃癌的有效治疗手段，但可能发生异时性胃肿瘤。本研究旨在评估自身免疫性胃炎对胃肿瘤内镜切除术后异时性胃肿瘤发生的临床影响。我们回顾性分析了接受胃肿瘤内镜切除术的患者，排除多发病灶、复发病灶或有胃部分切除史者。通过抗壁细胞抗体检测确定自身免疫性胃炎状态，比较自身免疫性胃炎组与非自身免疫性胃炎组的随访内镜结果及异时性肿瘤发生率。在569例患者中，282例接受抗壁细胞抗体检测，其中20例（7.1%）确诊自身免疫性胃炎。自身免疫性胃炎组的异时性胃肿瘤发生率显著高于非自身免疫性胃炎组（45.0% vs. 18.3%），但两组异时性肿瘤发生模式相似。多变量分析显示，自身免疫性胃炎（风险比3.32，95%置信区间1.55–7.10，p=0.002）和较高体重指数（风险比1.16，95%置信区间1.06–1.27，p=0.002）是与异时性胃肿瘤发生显著相关的独立因素。自身免疫性胃炎患者在接受胃肿瘤内镜切除术后具有更高的异时性病变发生风险。抗壁细胞抗体阳性结果对预测异时性胃肿瘤具有独立的临床意义，对此类患者进行规范监测与管理对早期发现和治疗复发性病变至关重要。
肿瘤(癌症)患者之家