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)-Reference-Cited by-同舟云学术

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)

Published:2024-07-05 Issue: Volume: Page:
ISSN:0002-9270
Container-title:American Journal of Gastroenterology
language:en
Short-container-title:Am J Gastroenterol

Author:

Lenti Marco Vincenzo¹²^ORCID,Miceli Emanuela¹,Lahner Edith³^ORCID,Natalello Gabriele¹²^ORCID,Massironi Sara⁴^ORCID,Schiepatti Annalisa¹⁵^ORCID,Zingone Fabiana⁶^ORCID,Sciola Valentina⁷,Rossi Roberta Elisa⁸^ORCID,Cannizzaro Renato⁹^ORCID,De Giorgi Elena Maria¹,Gregorio Virginia¹,Fazzino Erica¹,Gentile Antonella¹,Petrucci Clarissa¹^ORCID,Dilaghi Emanuele³^ORCID,Pivetta Giulia³^ORCID,Vanoli Alessandro¹⁰^ORCID,Luinetti Ombretta¹⁰^ORCID,Paulli Marco¹⁰,Anderloni Andrea¹¹^ORCID,Vecchi Maurizio⁷,Biagi Federico¹⁵^ORCID,Repici Alessandro⁸¹²,Savarino Edoardo Vincenzo⁶^ORCID,Joudaki Shamim¹²,Delliponti Mariangela²^ORCID,Pasini Alessandra²,Facciotti Federica¹³^ORCID,Farinati Fabio⁶,D'Elios Mario Milco¹⁴,Della Bella Chiara¹⁴^ORCID,Annibale Bruno³^ORCID,Klersy Catherine¹⁵^ORCID,Corazza Gino Roberto¹²^ORCID,Di Sabatino Antonio¹²^ORCID

Affiliation:

1. Department of Internal Medicine and Medical Therapeutics, University of Pavia, Pavia, Italy;

2. First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;

3. Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy;

4. Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, Fondazione IRCCS San Gerardo dei Tintori; University of Milano-Bicocca, Monza, Italy;

5. Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy;

6. Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy, Gastroenterology Unit, Azienda Ospedale-Università Padova, Padua, Italy;

7. Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy;

8. Gastroenterology and Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy;

9. Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy, Department of Medical, Surgical and Health Sciences, University of Trieste, Italy;

10. Unit of Anatomic Pathology, Department of Molecular Medicine, University of Pavia, and IRCCS San Matteo Hospital Foundation, Pavia, Italy;

11. Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;

12. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy;

13. IEO, European Institute of Oncology IRCCS, Department of Experimental Oncology, Milan, Italy; University of Milano-Bicocca, Department of Biotechnology and Biosciences, Milan, Italy;

14. Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy;

15. Biostatistics & Clinical Trial Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Abstract

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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