揭示自身免疫性胃炎:在早期胃癌的内镜下粘膜剖析后,多重结节痕的发展
Naoya Masuda1,2, Kenji Yamazaki1, Yasuhiko Maruyama3
1Department of Gastroenterology Gifu Prefectural General Medical Center Gifu Japan.
DEN open
|March 12, 2025
概括
聚类结节痕 (PNS) 在内镜下粘膜剖析 (ESD) 后可能会使早期胃癌评估复杂化. 这一案例表明,自身免疫性胃炎 (AIG) 可能导致由于高胃血症导致的持续性PNS,这是一个新发现.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 对于早期的胃癌,内镜下粘膜切割 (ESD) 通常形成平面痕.
- 聚类结节痕 (PNS) 可以发展,模仿复发和复杂的诊断.
- 一名60岁的男子在两次ESD手术后患有Helicobacter pylori感染史,患上了PNS.
研究的目的:
- 在内镜下粘膜切割 (ESD) 后报告一种持久的多质结节痕 (PNS) 病例.
- 调查持续PNS的潜在潜在原因.
- 为了突出自身免疫性胃炎 (AIG) 的诊断挑战,在有H. pylori感染史的患者中.
主要方法:
- 一个患者的病例报告,因为胃瘤而接受ESD.
- 在ESD痕部位开发病变的内镜监测和活检.
- 实验室检测包括血清胃素,素水平和抗体检测.
- 活检样本的病理检查.
主要成果:
- 一种持久的,红血性,突出的病变与PNS一致,在腹ESD痕部位发育.
- 活检显示出再生和超塑性组织.
- 尽管消除了H. pylori和抑制了酸性,但病变仍然扩大.
- 高 gastrin,低 pepsinogen,阳性 antiparietal 细胞抗体,和病理发现证实了自身免疫性胃炎 (AIG).
结论:
- 经过ESD后持久的PNS可能表明粘膜过度再生和增强的周平静,可能与高胃血症有关.
- 在这种情况下,自身免疫性胃炎 (AIG) 被确定为PNS潜在的潜在原因.
- 这是第一个报告的病例,表明AIG和PNS之间存在联系,强调了H. pylori感染患者的诊断挑战.
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