OBJECTIVE

Detailed study of the morphological characteristics of autoimmune gastritis (AIG), assessment of the possibilities and prospects for morphological diagnosis of this disease.

MATERIAL AND METHODS

The study included 63 patients with AIG and 25 patients with chronic atrophic gastritis, who were examined in the clinics of Sechenov University from 2021 to 2023.

RESULTS

During the study, it was found that in biopsies of the antrum of the stomach in 90.5% of patients with AIG predominated mild inactive inflammation (p<0.001), hyperplasia of smooth muscle cells and foveolar cells line were observed in 20.6% of cases (p=0.009), indicating reactive gastropathy. Moderate inflammation was found in the stomach body in 77% of cases, in 100% — atrophy of gastric glands, in 92% — pseudopyloric metaplasia (p<0.001). When evaluated on the OLGA scale, 79.4% of patients had grade II atrophy, when using the OLGIM scale, 66.7% of patients had grade I, when comparing the stages of OLGA and OLGIM, in 88.9% of cases, the values of the stages were lower in the last school.

CONCLUSION

The most frequently detected morphological criteria of AIG were: complete or partial loss of major glands; widespread pseudopyloric metaplasia; the presence of foci of complete intestinal metaplasia (less than 30% of the area of biopsies); increased density of inflammatory infiltrate in the basal sections of biopsies with the formation of lymphoid nodules and hyperplasia of neuroendocrine cells. There was no correlation between AIG and H. pylori infection (p<0.001). The use of the atrophy assessment system according to the OLGA international protocol demonstrated advantages over the OLGIM system, which underestimated the degree of atrophy.