Review article: gastric atrophy and atrophic gastritis - nebulous concepts in search of a definition
Review article: gastric atrophy and atrophic gastritis - nebulous concepts in search of a definition
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DOI：
10.1111/j.1365-2036.1998.00003.x
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发表时间：
1998-02-01
影响因子：
7.6
通讯作者：
Genta, RM
中科院分区：
文献类型：
--
作者：
Genta, RM
流行病学和生物学证据表明，萎缩性胃炎是肠型胃腺癌的重要危险因素。为了估计个体受试者患胃癌的风险，病理学家应该能够正确诊断和可靠评估胃萎缩。然而，轶事证据和最近的研究都表明，病理学家对胃萎缩的一致性很低。此外，术语“胃萎缩”和“萎缩性胃炎”的定义仍然不准确，进一步增加了组织病理学不精确的混乱。在最近更新的悉尼系统提出的视觉模拟量表的分类和分级的胃炎，最终可能会帮助病理学家实现更大程度的观察者之间的协议胃炎的组织病理学特征。然而，这不能实现在没有一个严格的和广泛接受的定义atrophytic.This文章的目的是简要回顾可能的发病途径导致胃粘膜萎缩性变化的发展，探讨其可逆性的问题，并提出一个工作定义，可能有助于提高诊断的重现性。
Epidemiological and biological evidence indicates that atrophic gastritis represents an important risk factor for gastric adenocarcinoma of the intestinal type. To estimate an individual subject's risk of gastric cancer, pathologists should be able to diagnose correctly and reliably assess gastric atrophy. However, both anecdotal evidence and recent studies suggest that pathologists have a low level of agreement on gastric atrophy. Moreover, the terms 'gastric atrophy' and 'atrophic gastritis' remain imprecisely defined, further adding confusion to the histopathological imprecision. The use of visual analogue scales proposed in the recently updated Sydney System for the classification and grading of gastritis may eventually help pathologists achieve a greater degree of interobserver agreement on the histopathological features of gastritis. However, this cannot be achieved in the absence of a stringent and widely accepted definition of atrophy.The purpose of this article is to review briefly the possible pathogenetic pathways leading to the development of atrophic changes in the gastric mucosa, explore the issue of its reversibility, and propose a working definition that could contribute to improved diagnostic reproducibility.