title: Oxyntic gastric atrophy in Helicobacter pylori gastritis is distinct from autoimmune gastritis.
abstract: OBJECTIVE
  To assess characteristics of oxyntic gastric atrophy (OGA) in autoimmune gastritis (AIG) compared with OGA as a consequence of Helicobacter pylori infection.
  
  
  METHODS
  Patients undergoing oesophagogastroduodenoscopy from July 2011 to October 2014 were prospectively included (N=452). Gastric biopsies were obtained for histology and H. pylori testing. Serum gastrin-17 (G17), pepsinogen (PG) I, PGII and antibodies against H. pylori and cytotoxin-associated gene A protein were determined in all patients. Antibodies against parietal cells and intrinsic factor were determined in patients with advanced (moderate to severe) OGA. Areas under the receiver operating characteristic curves (AUCs) were calculated for serum biomarkers and compared with histology.
  
  
  RESULTS
  Overall, 34 patients (8.9%) had advanced OGA by histology (22 women, age 61±15 years). Current or past H. pylori infection and AIG were present in 14/34 and 22/34 patients, respectively. H. pylori-negative AIG patients (N=18) were more likely to have another autoimmune disease (OR 6.3; 95% CI 1.3 to 29.8), severe corpus atrophy (OR 10.1; 95% CI 1.9 to 54.1) and corpus intestinal metaplasia (OR 26.9; 95% CI 5.3 to 136.5) compared with H. pylori-positive patients with advanced OGA. Antrum atrophy was present in 39% of H. pylori-negative AIG patients. The diagnostic performance of G17, PG I and PGI/II was excellent for AIG patients (AUC=0.83, 0.95 and 0.97, respectively), but limited for H. pylori-positive patients with advanced OGA (AUC=0.62, 0.75 and 0.67, respectively).
  
  
  CONCLUSIONS
  H. pylori-negative AIG has a distinct clinical, morphological and serological phenotype compared with advanced OGA in H. pylori gastritis.
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Marino
authors.initials: M
authors.lastname: Venerito
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Mariya
authors.initials: M
authors.lastname: Varbanova
authors.affiliation: Institute for Biometrics and Medical Informatics, Otto-von-Guericke-University Hospital, Magdeburg, Germany.
authors.forename: Friedrich-Wilhelm
authors.initials: FW
authors.lastname: Röhl
authors.affiliation: Institute of Molecular and Clinical Immunology, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Reinhold
authors.affiliation: Institute of Pathology, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Frauenschläger
authors.affiliation: Institute of Pathology, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Doerthe
authors.initials: D
authors.lastname: Jechorek
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Weigt
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Link
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University Hospital, Magdeburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000097:blood / Q000276:immunology / Q000473:pathology; D001327:Autoimmune Diseases / Q000097:blood / Q000276:immunology / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000276:immunology / Q000473:pathology*; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000097:blood / Q000276:immunology / Q000473:pathology*; D016481:Helicobacter Infections / Q000097:blood / Q000276:immunology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D005755:Gastrins; C013550:gastrin 17; D020116:Pepsinogen A
keywords: AUTOIMMUNITY; GASTRIC PATHOLOGY; HELICOBACTER PYLORI