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Autoimmune gastritis may be less susceptible to cancer development than Helicobacter pylori-related gastritis based on histological analysis
  1. Junya Arai1,2,
  2. Ryota Niikura1,3,
  3. Yoku Hayakawa1,
  4. Yoshihiro Hirata1,
  5. Tetsuo Ushiku4,
  6. Mitsuhiro Fujishiro1
  1. 1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  2. 2Departmemt of Gastroenterology, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan
  3. 3Gastroenterological Endoscopy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
  4. 4Department of Pathology, The University of Tokyo, Tokyo, Japan
  1. Correspondence to Dr Yoku Hayakawa, Department of Gastroenterology, Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Bunkyo-ku 113-8655, Japan; yhayakawa-tky{at}

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We read with great interest the recent publication by Rugge et al,1 in which the authors conducted a cohort study to evaluate the association between autoimmune gastritis (AIG) and gastric cancer (GC). No excess risk of gastric or other malignancies was observed over a cumulative follow-up time of 10 541 person-years, except for (marginally significant) thyroid cancer (standardised incidence ratio=3.09; 95 % CI 1.001 to 7.20). They concluded that, compared with the general population, corpus-restricted inflammation/atrophy observed in patients with AIG do not increase the risk of GC. The excess GC risk reported in patients with AIG may be influenced by unrecognised previous/current Helicobacter pylori comorbidity.

We previously reported 76 GC cases, positive for the antiparietal cell antibody (APCA) test; among them, 8 cases developed cancer in pure AIG stomachs without an apparent history of H. pylori infection.2 Nevertheless, in regions such as Japan, where the H. pylori infection rate is high, the diagnosis of AIG is often difficult because many patients who …

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  • Contributors JA, RN and YHa contributed to the study design. JA wrote the initial manuscript draft. JA, RN and YHi analysed the data. YHa, TU and MF provided guidance regarding the study design and contributed to manuscript editing.

  • Funding This study was supported by the KAKENHI Grants-in-Aid for Scientific Research (Grant Nos. 23H02744 (YHa) and 23K07448 (RN)) and AMED (PRIME and P-CREATE), respectively.

  • Disclaimer The funding agencies had no role in the study design, data collection, analysis, decision to publish, or manuscript preparation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.