최신연구결과(해외)

NeoplasmRole of Autoimmune Gastritis in Gastric Cancer.

관리자
2023-06-19
조회수 595

[CORRESPONDENCE]

Clin. Transl. Gastroenterol. 2019 Sep;10(9):e00080.


* It has been known for 70 years that gastric cancer occurs mainly in a stomach with gastritis. Gastritis was previously so prevalent that it was regarded as an aging phenomenon. However... 

* Hp was soon accepted as the most important gastric carcinogen. 

* Propose that hypergastrinemia due to reduced acid secretion leading to gastric hypoacidity was the pathogenic factor in Hp-associated gastric cancer.

* Autoimmune gastritis (AIG) has been accepted as a separate type of gastritis having a much lower prevalence than Hp gastritis. Hp and AIG have special traits (Table 1).

  

* Hp infection cannot be found at late phases of AIG does not preclude a Hp infection at earlier phases.

* After death of Hp, Hp antibodies will dwindle and finally disappear leading to negative serology. 

* AIG has for long been known to predispose to gastric carcinoma as well as gastric neuroendocrine tumors (NETs) originating from the target cell of gastrin, the enterochromaffin-like (ECL) cell.

* In AIG, the more marked hypergastrinemia leads to more pronounced stimulation of the ECL cell leading to ECL cell NETs as well as carcinomas (Table 2). 


* To conclude, the etiology of AIG is still unsettled, but AIG predisposes not only to gastric NETs, but also to gastric cancer. 

* Whether the cancer risk is so high that these patients should be followed by upper endoscopic surveillance has been discussed.

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이번 correspondence에서도 AIG가 gastric cancer (GC) 발생의 원인이라고 명시하고 있지만 carcinoma의 risk로 볼것인가에 대해서는 아직도 의견이 분분합니다. 즉, AIG와 NETs의 관계는 확실하지만, GC 관련해서는 아직도 명확하지 않습니다. GC 발생에는 많은 요인들이 작용하긴 하지만, AIG는 Hp 만큼 위험이 크지 않다는 정도로 이해하고 내용을 보시면 되겠습니다.

 

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