Chronic atrophic gastritis in no specific clinical manifestations, clinical manifestations and laboratory examinations, especially gastroscopy and gastric mucosal biopsy was diagnosed with chronic atrophic gastritis. Systematic introduction to the diagnosis of chronic atrophic gastritis based on the following:
(1) Clinical manifestations: loss of appetite, nausea, belching, abdominal fullness or dull, a small number of patients with upper gastrointestinal bleeding, weight loss, anemia, brittle A, glossitis or lingual papillae atrophy.
(2) laboratory tests
CAG patients ① gastric analysis: A type multi-acid-free or low-acid type B CAG patients may be normal or low acid.
The ② pepsinogen determination: originally the main cell of pepsin secretion, chronic atrophic gastritis, blood and urine pepsinogen decreased.
③ serum gastrin: G cells of the gastric antrum gastrin secretion. CAG type A patients, serum gastrin often significantly higher; atrophy of the antral mucosa of patients with B-type CAG, directly affect the G cells secrete gastrin, serum gastrin lower than normal.
④ immunological tests: the parietal cell antibodies (PCA), the intrinsic factor antibody (IFA), gastrin secretion cell antibody (GCA) measured as chronic atrophic gastritis and its sub-aided diagnosis.
(3) X-ray examination: X-line gastric barium meal examination the most atrophic gastritis patients without abnormal findings. Double contrast barium gastric body mucosal folds flat, thin, serrated mucosa of the greater curvature of the gastric body folds thinner or disappear, smooth the bottom of the stomach and part of the antral gastric mucosa was jagged or mucosal thick mess performance .
(4) endoscopy and biopsy: endoscopy and biopsy is the most reliable method of diagnosis. Endoscopic diagnosis should include lesions, atrophy, intestinal metaplasia and dysplasia of the degree. Naked eye observation of atrophic gastritis the mucosa showed mostly pale or gray, thinning or flat folds. Mucosa may show red and white, the serious with scattered white patches. The submucosal vascular revealed atrophic gastritis characteristics, you can see the red mesh small arteries or capillaries, severe atrophic gastritis, epithelial cell proliferation seen the formation of small particles or larger nodules. Also mucosal erosion, bleeding. Gastric mucosal biopsy glands varying degrees of atrophy and disappear, replaced by the gland metaplasia or intestinal metaplasia, interstitial inflammatory infiltration significantly.