Chen, Yu (Y);Ji, Xiaowei (X);Zhao, Weiyi (W);Lin, Jie (J);Xie, Siyuan (S);Xu, Jinghong (J);Mao, Jianshan (J);

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Clin Res Hepatol Gastroenterol.2025 Feb 15;49(4):102556.doi:10.1016/j.clinre.2025.102556

Abstract

BACKGROUND AND AIM: Autoimmune gastritis (AIG) was previously considered a rare disease in China, and its clinical characteristics were not fully understood. This study aimed to demonstrate the characteristics of AIG in China and evaluate gastric oxyntic mucosal atrophy using a modified AIG-atrophic staging.

METHODS: This was a single-center retrospective observational real-world study. The diagnosis of AIG was based on pathological results combined with parietal cell antibody (PCA) and intrinsic factor antibody (IFA) results, and endoscopic findings.

RESULTS: A total of 745 patients were enrolled, the median age at diagnosis was 58 years old, and 69.9 % were female. The symptoms of AIG patients were nonspecific, and about 2/5 of the cases were asymptomatic. The proportions of cases from modified AIG-atrophic stage 1 to 4 were 0.8 %, 14.1 %, 73.8 %, and 11.3 %, respectively. Approximately 1/5 had autoimmune thyroiditis (AITD). Near 1/2 had one or more comorbidities: iron-deficiency anemia (IDA), pernicious anemia (PA), neuropathy, gastric hyperplastic polyps (GHP), gastric intraepithelial neoplasia (GIN), type 1 gastric neuroendocrine tumors (g-NET), or gastric adenocarcinoma (GAC). There was a high risk of type 1 g-NET (7.0 %) and GAC (9.1 %) in AIG patients.

CONCLUSIONS: AIG is not rare in China, and its early diagnosis is challenging, accompanied by a high risk of GAC. The modified four-stage AIG-atrophic staging can effectively represent the extent of oxyntic mucosal atrophy and the progression in AIG.