Clinicopathological characteristics of autoimmune gastritis:an analysis of 39 cases

YUAN Xuya; LI Xiuqing; ZHANG Yi; WANG Yaohui; ZHANG Yifen

doi:10.3969/j.issn.1007-8096.2025.12.013

Abstract：Objective To investigate the clinicopathological features of autoimmune gastritis(AIG).Methods The clinical and pathological data of 39 patients with AIG by endoscopic biopsy from January 2022 to December 2024 were retrospectively analyzed.Results Among the 39 patients(23 confirmed cases and 16 suspected cases),25 were females and 14 were males.The age at onset ranged from 33 to 82 years,with a median age of 56 years.Endoscopically,the main manifestations were mucosal atrophy in the gastric body and fundus,while the gastric antrum was basically normal.Polypoid lesions were found in some patients.Histologically,the lamina propria of the gastric body and fundus showed infiltration of chronic inflammatory cells of varying degrees,a decrease in intrinsic glands accompanied by a reduction in parietal cells,intestinal metaplasia,(pseudo)pyloric gland metaplasia,and pancreatic acinar metaplasia.Neuroendocrine cell proliferative lesions/tumors were found in 37 cases:21 cases of neuroendocrine cell hyperplasia,2 cases of dysplasia,and 14 cases of neuroendocrine tumors.Laboratory tests revealed that 23 out of 27 patients were positive for anti-parietal cell antibody(APCA)and/or anti-intrinsic factor antibody(AIFA),and 20 out of 24 patients had elevated serum gastrin levels.The clinical manifestations of patients were non-specific.Among the 39 patients,12 cases had anemia,15 cases were complicated with other autoimmune disorders,and 2 cases had gastric adenocarcinoma.Conclusion AIG predominantly affects middle-aged women with non-specific clinical manifestations.When endoscopic examination finds gastric mucosal atrophy in the gastric body and fundus,especially in patients complicated with anemia or other autoimmune disorders,the diagnosis of AIG should be suspected.