内視鏡検診におけるA型胃炎

Type A Gastritis Detected During Endoscopic Examination

要旨●本邦ではA型胃炎は極めてまれな疾患とされてきたが，近年H. pylori未感染者や除菌後の受診者が増加しているためか，検診の場においてA型胃炎を疑う症例が増加している．当センターの一次内視鏡検診におけるA型胃炎は，2,591例中23例（0.89%）で，男性は1,168例中7例（0.60%），女性は1,423例中16例（1.12%）であった．しかし，A型胃炎の真の頻度はさらに高い可能性がある．今後は，A型胃炎の発症初期を含めた診断基準の確立，H. pylori感染との関連性の解明などが必要である．だが，何よりも内視鏡検診医自身が，本疾患を検診で拾い上げることの意義を理解し，特徴的な内視鏡所見を熟知しておくことが最も重要である．

　Type A gastritis is regarded as an extremely rare disease in Japan, but the number of suspected cases of this condition during screenings has increased, likely because the number of people who have not been infected with Helicobacter pylori and those who have been eradicated have recently increased. At our center, type A gastritis was detected during primary endoscopic examination in 23（0.89%）of 2,591 cases ［7（0.60%）of 1,168 males and 16（1.12%）of 1,423 females］. However, the natural frequency of type A gastritis may be even higher. Future studies must establish diagnostic criteria for type A gastritis including the early-onset disease, and it is necessary to clarify the relationship with H. pylori infection. However, above all, endoscopy physicians must understand the significance of screening for this disease and familiarize themselves with its characteristic endoscopic findings.