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Экспериментальная и клиническая гастроэнтерология

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Междисциплинарный консенсус RE.GA.IN.: взгляд гастроэнтеролога и эндоскописта

https://doi.org/10.31146/1682-8658-ecg-242-10-23-29

Аннотация

Хронический гастрит занимает одно из ведущих мест в структуре патологии верхних отделов желудочно-кишечного тракта, с которой встречаются практикующие специалисты смежных специальностей: гастроэнтерологи, терапевты, эндоскописты. Актуальная обобщающая система взглядов на данное заболевание представлена в консенсусе RE.GA.IN. (2024). Нами были выделены и структурированы наиболее прикладные положения консенсуса в контексте классификации и характеристики основных форм хронического гастрита, акцентированы подходы к диагностике и динамическому наблюдению, проиллюстрированы опорные эндоскопические критерии заболевания. Особое внимание уделено описанию эндоскопической картины нормы и патологии при использовании современных эндоскопических технологий, как интегральному фактору междисциплинарного взаимодействия клиницистов и диагностов. В своей работе мы постарались отдельно и развернуто затронуть проблему аутоиммунного подтипа заболевания как одной из наиболее клинически значимых в настоящий момент, но в то же время часто недооцененных форм хронического гастрита.

Об авторах

И. А. Подъяпольская
ООО «Аско-Мед-Плюс»
Россия


А. Н. Беляев
ООО «Аско-Мед-Плюс»; Краевое государственное бюджетное учреждение здравоохранения Алтайский краевой онкологический диспансер
Россия


Список литературы

1. Rugge M., Genta R.M., Malfertheiner P; RE.GA.IN; RE GA IN. RE.GA.IN.: the Real-world Gastritis Initiative-updating the updates. Gut. 2024 Feb 23;73(3):407-441. doi: 10.1136/gutjnl-2023-331164.

2. Carmack S.W., Lash R.H., Gulizia J.M., Genta R.M. Lymphocytic disorders of the gastrointestinal tract: a review for the practicing pathologist. Adv Anat Pathol. 2009 Sep;16(5):290-306. doi: 10.1097/PAP.0b013e3181b5073a.

3. Gocht A., Schumacher U. Description of the normal gastric mucosa in anatomy education: How many leukocytes are acceptable? Clin Anat. 2023 Apr;36(3):441-446. doi: 10.1002/ca.23976.

4. Dayharsh J., Burgart L.Q., A Column. Cap Today. College of American Pathologists. 2001. Available at: http://www.captodayonline.com/ Archives/q_and_a/qa_0701.html Accessed: 01.05.2025)

5. Yagi K., Aruga Y., Nakamura A. et al. Regular arrangement of collecting venules (rac): a characteristic endoscopic feature of helicobacter pylori- negative normal stomach and its relationship with esophago- gastric adenocarcinoma. J Gastroenterol. 2005;40:443-52.

6. Sugano K., Spechler S.J., El- Omar E.M. et al. Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro- oesophageal junction. Gut 2022;71:1488-514.

7. Glover B., Teare J., Patel N. A systematic review of the role of non-magnified endoscopy for the assessment of H. pylori infection. Endosc.Int. Open. 2020; 8 (2): E105-E114.

8. Yuan C., Lin X. - M., Ou Y. et al. Association between regular arrangement of collecting venules and Helicobacter Pylori status in routine endoscopy. BMC. Gastroenterol. 2021;21:389.

9. Villani L., Trespi E., Fiocca R. et al. Analysis of gastroduodenitis and oesophagitis in relation to dyspeptic/reflux symptoms. Digestion. 1998;59:91-101.

10. Trespi E., Broglia F., Villani L. et al. Distinct profiles of gastritis in dyspepsia subgroups. their different clinical responses to gastritis healing after helicobacter pylori eradication. Scand J Gastroenterol. 1994;29:884-8.

11. Banks M., Graham D., Jansen M. et al. British society of gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma. Gut. 2019;68:1545-75.

12. GBD 2017 Stomach Cancer Collaborators. The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017: a systematic analysis for the global burden of disease study 2017. Lancet Gastroenterol Hepatol. 2020;5:42-54.

13. Yan L., Chen Y., Chen F. et al. Effect of helicobacter pylori eradication on gastric cancer prevention: updated report from a randomized controlled trial with 26.5 years of follow- up. Gastroenterology. 2022;163:154-62.

14. Chiang T- H., Chang W- J., Chen SL- S. et al. Mass eradication of helicobacter pylori to reduce gastric cancer incidence and mortality: a long- term cohort study on matsu Islands. Gut. 2021;70:243-50.

15. Hooi JKY., Lai W.Y., Ng W.K. et al. Global prevalence of helicobacter pylori infection: systematic review and meta- analysis. Gastroenterology 2017; 153:420-9.

16. Dixon M.F., Genta R.M., Yardley J.H. et al. Classification and grading of gastritis. The updated Sydney system.International workshop on the histopathology of gastritis, Houston 1994. Am J Surg Pathol. 1996;20:1161-81.

17. Rugge M., Correa P., Dixon M.F. et al. Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther. 2002;16:1249-59.

18. Shah S.C., Piazuelo M.B., Kuipers E.J. et al. AGA clinical practice update on the diagnosis and management of atrophic gastritis. Gastroenterology. 2021;161:1325-1332.

19. Malfertheiner P., Megraud F., Rokkas T. et al. Management of helicobacter pylori infection: the maastricht VI/florence consensus report. Gut. 2022. doi: 10.1136/ gutjnl-2022-327745.

20. Bordin D.S., Mozgovoy S.I., Livzan M.A., et al.Interdisciplinary consensus RE.GA.IN.: what’s new? Part 1: definitions, Helicobacter pylori-associated and autoimmune gastritis. Effective Pharmacotherapy. 2024; 20 (2): 54-70. (in russ) soi: 10.33978/2307-3586-2024-20-2-54-70.@@ Бордин Д.С., Мозговой С.И., Ливзан М.А. и др. Междисциплинарный консенсус RE.GA.IN.: что нового? Часть 1: дефиниции, Нelicobacter pylori-ассоциированный и аутоиммунный гастрит. Эффективная фармакотерапия. 2024; 20 (2): 54-70. soi: 10.33978/2307-3586-2024-20-2-54-70

21. Pimentel- Nunes P., Libânio D., Marcos- Pinto R. et al. Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European society of gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota study group (EHMSG), European society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 2019. Endoscopy. 2019;51:365-88.

22. Kawamura M., Uedo N., Koike T. et al. Kyoto classification risk scoring system and endoscopic grading of gastric intestinal metaplasia for gastric cancer: multicenter observation study in Japan. Dig Endosc. 2022;34:508-16.

23. Uemura N., Okamoto S., Yamamoto S., et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345:784-9.

24. Akbari M., Tabrizi R., Kardeh S., Lankarani K.B. Gastric cancer in patients with gastric atrophy and intestinal metaplasia: a systematic review and meta-analysis. PLoS One. 2019; 14 (7): e0219865.

25. Bisschops R., Areia M., Coron E. et al. Performance measures for upper gastrointestinal endoscopy: a European society of gastrointestinal Endoscopy (ESGE) quality improvement initiative. Endoscopy. 2016;48:843-64.

26. Ekkelenkamp V.E., Koch A.D., de Man R.A. et al. Training and competence assessment in GI endoscopy: a systematic review. Gut. 2016;65:607-15.

27. Forbes N., Mohamed R., Raman M. Learning curve for endoscopy training: is it all about numbers. Best Pract Res Clin Gastroenterol. 2016;30:349-56.

28. Marcos P., Brito- Gonçalves G., Libânio D. et al. Endoscopic grading of gastric intestinal metaplasia on risk assessment for early gastric neoplasia: can we replace histology assessment also in the west Gut. 2020;69:1762-8.

29. Vasapolli R., Neuhaus L., Schirra J. et al. Microscopic alterations of the gastric mucosa in preneoplastic lesions as assessed by new- generation endocytoscopy. Endoscopy 2023;55: E998-1000.

30. Uedo N., Ishihara R., Iishi H. et al. A new method of diagnosing gastric intestinal metaplasia: narrow- band imaging with magnifying endoscopy. Endoscopy. 2006;38:819-24.

31. Yao K., Iwashita A., Tanabe H. et al. White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow- band imaging: a new optical sign for differentiating between adenoma and carcinoma. Gastrointest Endosc. 2008;68:574-80.

32. Pfefferle P.I., Keber C.U., Cohen R.M. et al. The hygiene hypothesis - learning from but not living in the past. Front Immunol. 2021;12:635935.

33. Osmola M., Hemont C., Chapelle N. et al. Atrophic gastritis and autoimmunity: results from a prospective, multicenter study. Diagnostics (Basel). 2023;13:1599.

34. Rustgi S.D., Bijlani P., Shah S.C. Autoimmune gastritis, with or without pernicious anemia: epidemiology, risk factors, and clinical management. Therap. Adv. Gastroenterol. 2021; 14: 17562848211038771.

35. Miceli E., Vanoli A., Lenti M.V. et al. Natural history of autoimmune atrophic gastritis: a prospective, single centre, long-term experience. Aliment. Pharmacol. Ther. 2019; 50 (11-12): 1172-1180.

36. Lenti M.V., Rugge M., Lahner E. et al. Autoimmune gastritis. Nat Rev Dis Primers. 2020;6:56.

37. Venerito M., Radünz M., Reschke K. et al. Autoimmune gastritis in autoimmune thyroid disease. Aliment Pharmacol Ther. 2015;41:686-93.

38. Kalkan Ç., Soykan I. Polyautoimmunity in autoimmune gastritis. Eur J Intern Med. 2016;31:79-83.

39. Rodriguez- Castro K.I., Franceschi M., Miraglia C, et al. Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed. 2018;89:100-3.

40. Boutzios G., Koukoulioti E., Goules A.V. et al. Hashimoto thyroiditis, anti- parietal cell antibodies: associations with autoimmune diseases and malignancies. Front Endocrinol (Lausanne). 2022;13:860880.

41. Rugge M., Bricca L., Guzzinati S. et al. Autoimmune gastritis: long- term natural history in naive helicobacter pylori- negative patients. Gut. 2023;72:30-8.

42. Rugge M., Fassan M., Pizzi M. et al. Autoimmune gastritis: histology phenotype and OLGA staging. Aliment Pharmacol Ther. 2012;35:1460-6.

43. Neumann W.L., Coss E., Rugge M. et al. Autoimmune atrophic gastritis- pathogenesis, pathology and management. Nat Rev Gastroenterol Hepatol. 2013;10:529-41.

44. Kotera T., Yamanishi M., Kushima R. et al. Early autoimmune gastritis presenting with a normal endoscopic appearance. Clin J Gastroenterol. 2022;15:547-52.

45. Kishikawa H., Nakamura K., Ojiro K. et al. Relevance of pepsinogen, gastrin, and endoscopic atrophy in the diagnosis of autoimmune gastritis. Sci Rep. 2022;12:4202.

46. Goldenring J.R. Pyloric metaplasia, pseudopyloric metaplasia, ulcer- associated cell lineage and spasmolytic polypeptide- expressing metaplasia: reparative lineages in the gastrointestinal mucosa. J Pathol. 2018;245:132-7.

47. Coati I., Fassan M., Farinati F. et al. Autoimmune gastritis: pathologist’s viewpoint. World J Gastroenterol. 2015;21:12179-89.

48. Esposito G., Dilaghi E., Cazzato M. et al. Endoscopic surveillance at 3 years after diagnosis, according to European guidelines, seems safe in patients with atrophic gastritis in a low- risk region. Dig Liver Dis. 2021;53:467-73.

49. Chen C., Yang Y., Li P. et al. Incidence of gastric Neoplasms arising from autoimmune Metaplastic atrophic Gastritis: a systematic review and case reports. JCM. 2023;12:1062.

50. Goldenring J. No h. pylori, no adenocarcinoma for patients with autoimmune gastritis. Gut. 2023;72:1-2.


Рецензия

Для цитирования:


Подъяпольская И.А., Беляев А.Н. Междисциплинарный консенсус RE.GA.IN.: взгляд гастроэнтеролога и эндоскописта. Экспериментальная и клиническая гастроэнтерология. 2025;(10):23-29. https://doi.org/10.31146/1682-8658-ecg-242-10-23-29

For citation:


Podyapolskaya I.A., Beliaev A.N. Interdisciplinary consensus RE.GA.IN.: view from the gastroenterologist and endoscopist. Experimental and Clinical Gastroenterology. 2025;(10):23-29. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-242-10-23-29

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