Seronegative autoimmune atrophic gastritis is more common in elderly patients
Seronegative autoimmune atrophic gastritis is more common in elderly patients
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DOI：
10.1016/j.dld.2020.04.015
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发表时间：
2020-11-01
影响因子：
4.5
通讯作者：
Lahner, Edith
中科院分区：
文献类型：
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作者：
Conti, Laura;Lenti, Marco Vincenzo;Lahner, Edith
背景资料：自身免疫性萎缩性胃炎（AAG）的诊断是基于特定的组织学检查结果和抗壁细胞抗体（PCA）被认为是AAG的血清学标志，虽然一个亚组的AAG患者可能是seronegress.Objectives：为了评估血清阴性的发生率和临床特征相比，血清阳性AAG。研究方法：这是一项横断面研究，包括516例连续成人患者（年龄59.6 ± 12.8岁，F：M = 2.2：1），在过去10年中，在两个意大利学术转诊中心诊断出经组织学证实的AAG。AAG诊断时检测到PCA。相关的因变量的利益（即PCA阴性）的变量进行了评估，通过单变量/Logistic回归analysis.Results：109/516 AAG患者血清阴性。血清阴性AAG患者的平均年龄明显高于PCA阳性患者（65.9 +/- 14.1vs57.9 +/- 15.1岁; p= 80岁）PCA阳性率分别较低（5.1 vs 12.8%; 21.3 vs 38.5%; p= 50岁（OR 2.4; 95%CI 1.1-5.2），而对于其他变量在101名AAG患者的子队列中，通过ELISA检测的PCA水平与AAG诊断时的年龄呈负相关，（rho=-0.250;p = 0.0118）。结论：大约20%的患者在AAG组织学诊断时为血清阴性，这在老年个体中更常见。(C)2020 Editrice Gastroenterology Italiana S.r.l.由爱思唯尔有限公司出版。保留所有权利。
Background: Autoimmune atrophic gastritis (AAG) diagnosis is based on specific histological findings and anti-parietal cell antibodies (PCA) considered the serological hallmark of AAG, although a subgroup of AAG patients may be seronegative.Objectives: To assess the occurrence and clinical features of seronegative compared to seropositive AAG. Methods: This is a cross-sectional study including 516 consecutive adult patients (age 59.6 +/- 12.8 years, F:M = 2.2:1) with histologically proven AAG diagnosed in two Italian academic referral centers over the last 10 years. PCA were detected at AAG diagnosis. Variables related to the dependent variable of interest (i.e.PCA-negativity) were assessed by univariate/logistic regression analysis.Results: 109/516 AAG patients were seronegative. The mean age of seronegative AAG patients was significantly higher compared to PCA-positive (65.9 +/- 14.1vs57.9 +/- 15.1 years; p= 80 years were, respectively, lower for PCA-positivity (5.1 vs 12.8%; 21.3 vs 38.5%; p= 50 years (OR 2.4;95 % CI 1.1-5.2), while for other variables (gender, comorbidities, anemia, atrophy severity) no association was found. In a sub-cohort of 101 AAG patients, PCA levels detected by ELISA were inversely correlated with age at AAG diagnosis (rho=-0.250;p = 0.0118).Conclusion: Roughly 20% of patients are seronegative at the time of AAG histological diagnosis and this is more common in elderly individuals. (C) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.