Table_1_Unveiling early stage autoimmune gastritis: novel endoscopic insights from two case reports.docx

The predominant characteristic of autoimmune gastritis (AIG) is corpus-dominant advanced atrophy, which is mostly observed in the middle to late stages. More reports are needed on the endoscopic features of the early stage. In this report, we present two cases of early-stage AIG in which endoscopic examinations showed no atrophy of the gastric mucosa but displayed a transition of collecting venules from a regular to an irregular arrangement. In addition, yellowish-white cobblestone-like elevations were observed in the fundic gland region. Histologically, the observed manifestations included pseudohypertrophy and protrusion of parietal cells into the lumen, possibly along with hyperplasia of G cells, lymphocytic infiltration and potentially pseudopyloric gland metaplasia. Serologically, the anti-parietal cell antibody returned positive results, whereas the anti-intrinsic factor antibody yielded negative results. In this study, we summarized some endoscopic features of two patients, aiming to provide clues for endoscopists to detect early-stage AIG.

自身免疫性胃炎（autoimmune gastritis, AIG）的主要特征为以胃体为主的进展性萎缩，该表现多出现于疾病中晚期。目前针对早期自身免疫性胃炎的内镜特征相关报道仍较为匮乏。本报告纳入2例早期自身免疫性胃炎病例，内镜检查未发现胃黏膜萎缩，但可见集合小静脉（collecting venules）的排列由规则转为不规则。此外，胃底腺区（fundic gland region）可见黄白色鹅卵石样隆起。组织学层面可见：壁细胞（parietal cells）假性肥大并向管腔突出，可伴随G细胞（G cells）增生、淋巴细胞浸润（lymphocytic infiltration），或可见假幽门腺化生（pseudopyloric gland metaplasia）。血清学检测显示抗壁细胞抗体（anti-parietal cell antibody）呈阳性，而抗内因子抗体（anti-intrinsic factor antibody）为阴性。本研究总结了2例患者的内镜特征，旨在为内镜医师早期识别自身免疫性胃炎提供参考依据。