Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the presence of atrophy in the oxyntic mucosa due to anti-parietal cell antibodies. This review provides a comprehensive and up-to-date overview of autoimmune atrophic gastritis, reporting recent evidence on epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management. The prevalence of AAG has been estimated at between 0.3% and 2.7% in the general population. The diagnosis of AAG is based on a combination of the serologic profile and the histological examination of gastric biopsies. Patients with AAG are often asymptomatic but can also have dyspeptic or reflux symptoms. The atrophy of the oxyntic mucosa leads to iron and vitamin B12 malabsorption, which may result in anemia and neurological affections. Autoimmune atrophic gastritis is associated with an increased risk of type I neuroendocrine tumors (NETs) and gastric cancer, with an incidence rate of 2.8% and 0.5% per person/year, respectively. Management is directed to reinstate vitamins and iron and to prevent malignancies with endoscopic surveillance. In conclusion, atrophic autoimmune gastritis is an infrequent condition, often asymptomatic and misdiagnosed, that requires an early diagnosis for appropriate vitamin supplementation and endoscopic follow-up for the early diagnosis of NETs and gastric cancer.
自身免疫性萎缩性胃炎是一种慢性疾病，其特征是由于抗壁细胞抗体导致胃底腺黏膜萎缩。本综述对自身免疫性萎缩性胃炎进行全面且最新的概述，报告了其在流行病学、发病机制、诊断、临床表现、恶性肿瘤风险及治疗管理方面的最新证据。据估计，普通人群中自身免疫性萎缩性胃炎的患病率在0.3%至2.7%之间。该病的诊断需结合血清学特征与胃黏膜活检组织学检查。患者常无症状，但也可能出现消化不良或反流症状。胃底腺黏膜萎缩会导致铁和维生素B12吸收障碍，可能引发贫血和神经系统损害。自身免疫性萎缩性胃炎与I型神经内分泌肿瘤和胃癌风险增加相关，其年发病率分别为2.8%和0.5%。治疗管理旨在补充维生素和铁剂，并通过内镜监测预防恶性肿瘤。总之，萎缩性自身免疫性胃炎是一种较少见且常无症状、易被误诊的疾病，需要早期诊断以进行适当的维生素补充，并通过内镜随访实现神经内分泌肿瘤和胃癌的早期诊断。
肿瘤(癌症)患者之家