References

urmj

Уральский медицинский журнал

Ural Medical Journal

2949-4389

Ural State Medical University

10.52420/umj.24.1.123

WHGTMQ

urmj-1730

Research Article

Литературные обзоры | Literature reviews

Literature reviews

Роль морфологического исследования в диагностике хронического аутоиммунного гастрита: обзор литературы

The Role of Morphological Examination in The Diagnosis of Chronic Autoimmune Gastritis: A Literature Review

https://orcid.org/0000-0003-1766-8608

Мороз

Г. А.

Moroz

G. A.

Глеб Александрович Мороз — ассистент кафедры патологической анатомии и судебной медицины, институт клинической медицины;

старший преподаватель кафедры медицинской биохимии и биофизики, институт естественных наук и математики

Екатеринбург

Gleb A. Moroz — Assistant of the Department of Pathological Anatomy and Forensic Medicine, Institute of Clinical Medicine;

Senior Lecturer of the Department of Medical Biochemistry and Biophysics, Institute of Natural Sciences and Mathematics

Ekaterinburg

glebmorozmd@gmail.com

https://orcid.org/0000-0002-9978-4807

Труфаненко

Р. А.

Trufanenko

R. A.

Роман Андреевич Труфаненко — ассистент кафедры патологической анатомии и судебной медицины, институт клинической медицины

Екатеринбург

Roman A. Trufanenko — Assistant of the Department of Pathological Anatomy and Forensic Medicine, Institute of Clinical Medicine

Ekaterinburg

rtrufanenko@gmail.com

https://orcid.org/0000-0002-5479-3216

Гринберг

Л. М.

Grinberg

L. M.

Лев Моисеевич Гринберг — доктор медицинских наук, профессор, профессор кафедры патологической анатомии и судебной медицины, институт клинической медицины

Екатеринбург

Lev M. Grinberg — Doctor of Sciences (Medicine), Professor, Professor of the Department of Pathological Anatomy and Forensic Medicine, Institute of Clinical Medicine

Ekaterinburg

lev_grin@mail.ru

https://orcid.org/0000-0001-7935-3578

Бердников

Р. Б.

Berdnikov

R. B.

Роман Борисович Бердников — кандидат медицинских наук, доцент, доцент кафедры патологической анатомии и судебной медицины, институт клинической медицины

Екатеринбург

Roman B. Berdnikov — Candidate of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Pathological Anatomy and Forensic Medicine, Institute of Clinical Medicine

Ekaterinburg

berdnikov@yandex.ru

https://orcid.org/0000-0001-6841-1197

Данилова

И. Г.

Danilova

I. G.

Ирина Георгиевна Данилова — доктор биологических наук, профессор, профессор кафедры медицинской биохимии и биофизики, институт естественных наук и математики

Екатеринбург

Irina G. Danilova — Doctor of Sciences (Biology), Professor, Professor of the Department of Medical Biochemistry and Biophysics, Institute of Natural Sciences and Mathematics

Ekaterinburg

ig-danilova@yandex.ru

https://orcid.org/0000-0002-3767-2869

Сорокина

Н. Д.

Sorokina

N. D.

Наталья Дмитриевна Сорокина — патологоанатом

Екатеринбург

Natalia D. Sorokina — Clinical Pathologist

Ekaterinburg

sorokina.nd@yandex.ru

https://orcid.org/0009-0003-8025-515X

Абдурагимова

Л. З.

Abduragimova

L. Z.

Лейла Закировна Абдурагимова — ассистент кафедры госпитальной терапии, институт клинической медицины

Екатеринбург

Leyla Z. Abduragimova — Assistant of the Department of Hospital Medicine, Institute of Clinical Medicine

Ekaterinburg

abduragimova92@yandex.ru

https://orcid.org/0000-0002-0944-9811

Хлынов

И. Б.

Khlynov

I. B.

Игорь Борисович Хлынов — доктор медицинских наук, доцент кафедры госпитальной терапии, институт клинической медицины

Екатеринбург

Igor B. Khlynov — Doctor of Sciences (Medicine), Associate Professor of the Department of Hospital Medicine, Institute of Clinical Medicine

Ekaterinburg

hlinov.doc@yandex.ru

Уральский государственный медицинский университет; Уральский федеральный университет имени первого Президента России Б. Н. ЕльцинаРоссияUral State Medical University; Ural Federal University named after the first President of Russia B. N. YeltsinRussian Federation

Уральский государственный медицинский университетРоссияUral State Medical UniversityRussian Federation

Уральский федеральный университет имени первого Президента России Б. Н. ЕльцинаРоссияUral Federal University named after the first President of Russia B. N. YeltsinRussian Federation

Областная детская клиническая больницаРоссияRegional Children’s Clinical HospitalRussian Federation

2025

03032025

241

123–141

2025

Мороз Г.А., Труфаненко Р.А., Гринберг Л.М., Бердников Р.Б., Данилова И.Г., Сорокина Н.Д., Абдурагимова Л.З., Хлынов И.Б.

Moroz G.A., Trufanenko R.A., Grinberg L.M., Berdnikov R.B., Danilova I.G., Sorokina N.D., Abduragimova L.Z., Khlynov I.B.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.umjusmu.ru/jour/article/view/1730

Введение. В развитых странах наблюдается тенденция к снижению распространенности гастрита, ассоциированного с H. pylori, что ведет к увеличению относительной частоты хронического аутоиммунного гастрита в структуре поражений желудка при исследовании биопсийного материала. Наблюдаемые тенденции, а также предполагаемый недостаточный уровень диагностики аутоиммунного гастрита в России делают актуальным обсуждение принципов диагностики этого заболевания.Цель работы — привести современные данные по критериям морфологической диагностики хронического аутоиммунного гастрита.Материалы и методы. Поиск данных по проблеме осуществлен в базах научных публикаций PubMed, Web of Science, Scopus, eLibrary.ru. Глубина научного поиска составила 175 лет (1849–2024 гг.).Результаты и обсуждение. Диагностика аутоиммунного гастрита сводится к эндоскопическому исследованию с забором биоптатов по диагностическому протоколу OLGA и модифицированной Сиднейской системе (антральный отдел, угол и тело желудка). При этом серологические методы (обнаружение специфических антител) не всегда позволяют подтвердить или опровергнуть диагноз, ввиду существования серонегативного варианта заболевания, что определяет первостепенную роль морфологического исследования. Постепенное разрушение париетальных клеток под действием аутоиммунного процесса приводит к широкому спектру морфологических изменений, которые проходят ряд стадий: от глубокой воспалительной инфильтрации области тела и дна желудка до тяжелой атрофии с различными вариантами метаплазии (прежде всего псевдопилорической). Практикующему патологоанатому важно уметь проводить дифференциальную диагностику аутоиммунного гастрита от H. pylori-ассоциированного гастрита, постхеликобактерного атрофического гастрита, особым диагностическим вызовом является сочетание H. pylori гастрита с аутоиммунным.Заключение. Хронический аутоиммунный гастрит является диагнозом, в постановке которого участвуют гастроэнтеролог, эндоскопист, патологоанатом. Определена и обоснована ведущая роль морфологических методов в диагностике хронического аутоиммунного гастрита.

Introduction. In developed countries, there is a trend towards a decrease in the prevalence of H. Pylori associated gastritis, which leads to an increase in the relative frequency of chronic autoimmune gastritis in the structure of gastric lesions in biopsy material. The observed trends, as well as the presumed underdiagnosis of autoimmune gastritis in the Russian Federation make it relevant to discuss the principles of diagnostics of this disease.Objective. Provide current data on the criteria for morphological diagnosis of chronic autoimmune gastritis.Materials and methods. Data on the problem were searched in the databases of scientific publications PubMed, Web of Science, Scopus, eLibrary.ru. The depth of the scientific search was 175 years (1849–2024).Results and discussion. The diagnosis of autoimmune gastritis is reduced to endoscopic examination with biopsy sampling according to the OLGA/Modified Sydney System diagnostic protocol (antral, incisura anglularis and body of the stomach). At the same time serological methods (detection of specific antibodies) do not always allow to confirm or refute the diagnosis, due to the existence of seronegative variant of the disease, which determines the primary role of morphological examination. The publication discusses the differential diagnosis of different stages of autoimmune gastritis with other types of chronic gastritis.Conclusion. Chronic autoimmune gastritis is a diagnosis that involves a gastroenterologist, endoscopist, and pathologist. The leading role of morphological methods in the diagnosis of chronic autoimmune gastritis is determined and substantiated.

аутоиммунный гастритатрофический гастритхронический гастритOLGARE.GA.INморфологическая диагностика

autoimmune gastritisatrophic gastritischronic gastritisOLGARE.GA.INmorphological diagnostics

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The authors declare that there are no conflicts of interest present.