Clinicopathological characteristics of early gastric cancer associated with autoimmune gastritis

Abstract

Background Autoimmune gastritis is known to be associated with neoplastic lesions but the relationship between autoimmunity and tumorigenesis have not been sufficiently clarified. The aim of this study is to assess the clinicopathological characteristics of gastric cancer cases associated with autoimmune gastritis. Methods A total of 24 patients diagnosed as early gastric cancer with autoimmune gastritis were registered. Chart reviews with the data including age, gender, state of Helicobacter pylori infection, comorbidity, and concomitant gastric diseases were conducted. As for the characteristics of gastric cancer, location, size, morphological type, histopathology, invasion depth, and the presence of metachronous or simultaneous lesion were assessed. These data from autoimmune gastritis group were compared with those from 301 patients of early gastric cancer as a control group. Results The gastric cancer associated with autoimmune gastritis was located in the upper, middle, and lower parts in 28.1%, 53.1%, and 18.8%, respectively. The morphological types are as follows: 0‐I, 9.4%; 0‐IIa, 28.1%; 0‐IIb, 15.6%; 0‐IIc, 46.9%; and 0‐III, 0.0%. The mean tumor size was 21.8 mm. While 90.6% were confined to the mucosa, 9.4% showed submucosal invasion. The histological classifications are as follows: tub1, 50.0%; tub2, 15.6%; pap, 21.9%; sig, 9.4%; and por, 3.1%. More numbers of female, protruded types, larger tumor size, papillary tumor, and that in the upper location were observed in autoimmune gastritis group compared to control group. Conclusion Early gastric cancer associated with autoimmune gastritis demonstrated different characteristics from those without autoimmune gastritis including variety of tumor morphologies and histological types with female dominancy.

Update in Molecular Aspects and Diagnosis of Autoimmune Gastritis

“…In a Japanese cohort, the prevalence was 11.4% for type 1 neuroendocrine tumors and 9.8% for adenocarcinomas [56]. A distinct pattern was also observed in the distribution of tumors in patients with gastric cancer associated with autoimmune gastritis [62]. Regarding the spatial sites of gastric cancer, 28.1%, 53.1%, and 18.8% were located in the upper, middle, and lower regions, respectively.…”

Emergency Endoscopic Hemostasis Using the Endoscopic Mucosal Resection Technique for Severe Bleeding From Early Gastric Cancer: A Case Report

“…A recent study reported a pooled annual gastric cancer incidence of 0.14% in autoimmune gastritis, with its overall relative risk for gastric cancer being 11.05 [ 12 ]. In addition, Kitamura et al characterized gastric cancers associated with autoimmune gastritis as protruded types, involving large tumor sizes, upper tumor locations, and papillary pathological types, with most of these being intramucosal [ 13 ]. The synchronous triple gastric cancers diagnosed in this case were shown to be consistent with the characteristics noted above.…”

Diagnostic criteria and endoscopic and histological findings of autoimmune gastritis in Japan

“…Possible factors contributing to the increase in AIG include the promotion of endoscopic screening; group D (negative for H. pylori and positive for pepsinogen [PG] [5]) findings in gastric cancer risk stratification tests; evaluation for macrocytic anemia [6], iron deficiency anemia, thyroid disease [7][8][9], and gastric cancer [10][11][12][13][14][15][16]; close examination of gastric neuroendocrine tumors (NETs) [17][18][19][20][21][22][23][24]; and the presence of AIG in a subset of repeat cases of H. pylori eradication by 13 C-urea breath test (UBT) [25]. Terao et al [26] retrospectively reviewed the clinical and endoscopic characteristics of 245 AIG cases collected from 11 institutions in Japan and showed that the best diagnostic indicators for AIG were endoscopic findings (31.2%), followed by macrocytic anemia (16.1%), and repeated H. pylori eradication due to 13 C-UBT false positivity (15.1%).…”