从机制到治疗:自身免疫性萎缩性胃炎和1型胃神经内分泌肿瘤

From etiopathogenesis to management:autoimmune atrophic gastritis and type 1 gastric neuroendocrine tumors

自身免疫性萎缩性胃炎(autoimmune atrophic gastritis,AAG)是一种局限于胃底、胃体黏膜的器官特异性自身免疫性疾病,可合并或继发多种疾病,其中包括1型胃神经内分泌肿瘤(gastric neuroendocrine tumors,g-NETs)。1型g-NETs是在AAG发病基础上引起肠嗜铬样(enterochromaffin-like,ECL)细胞系列增生而导致的一种生长缓慢但易复发的罕见恶性肿瘤。近年来,由于诊断技术的进步以及医生对疾病意识的提高,两种疾病的发病率呈逐年上升的趋势,得到了临床医生的重视。本文从AAG和1型g-NETs的发病机制、诊断和治疗以及二者之间的区别和联系等方面展开综述,以期为临床医生提供借鉴。

Autoimmune atrophic gastritis(AAG)is an organ-specific autoimmune disease limited to the gastric fundus and corpus mucosa,which can be combined with various diseases,including type 1 gastric neuroendocrine tumors(g-NETs).Type 1 g-NETs is a rare malignant tumor that grows slowly but is prone to recurrence,which is caused by the proliferation of enterochromaffin-like cells on the basis of AAG.In recent years,due to the improvement of diagnostic technology and raising of awareness of the diseases,the incidence of these diseases has been increasing gradually which has been paid attention by clinicians.In this article,a comprehensive review on the etiopathogenesis,diagnosis and treatment for AAG and type 1 g-NETs and the relations between the two kinds of diseases was carried out,in order to provide references for clinical practice.