Atrophic chronic gastritis and intestinal metaplasia in gastric carcinoma. Comparison with a representative population sample

Abstract

The occurrence of chronic gastritis and intestinal metaplasia (IM) was studied in 257 patients with gastric carcinoma (GC). In all cases biopsies were available from the benign mucosal area adjacent to the tumor, and in 139 patients from the antrum and/or body mucosa outside the tumor. The results were compared with endoscopically and bioptically examined noncancer controls representing a large Finnish population sample. For every GC patient, a control subject was matched by age and sex. In addition, a mean age‐adjusted score (AAS) of chronic gastritis, which expresses the progression of gastritis in GC patients as compared with that in the general population, was calculated for GC patients. The prevalences of chronic and atrophic gastritis in the antrum and body mucosa were similar in GC patients and controls when carcinoma cases were not more specifically classified according to histologic type or location of tumors. On the other hand, the location of the tumor showed a significant relation to gastritis: the progression of gastritis was more rapid (high mean AAS value) and the prevalence of atrophic gastritis was higher in the tumor‐affected area (i.e., in the antrum in patients with antral [distal] tumors; in the body in patients with body [proximal] tumors), than in the general population, but were similar in the tumor‐free area in both GC patients and controls. In the intestinal type of GC (IGC), the prevalence of chronic gastritis was higher and its progression was more rapid than in controls. In the diffuse type of GC (DGC), these correlations were less distinct. In GC patients, the IM adjacent to and outside the tumor area was significantly more common and extensive than in the corresponding area of controls, and a significant positive correlation was present between the location of the tumor and the distribution of IM. Like gastritis, the IM showed a closer relationship to IGC than to DGC. In all cases of GC and particularly of IGC, the antral mucosa tended to be more severely affected by gastritis and IM than the body mucosa, i.e., the prevailing type of gastritis found in this GC series was that morphologically corresponding to the so‐called B‐type of chronic gastritis.

Increased risk of gastric cancer in males affects the intestinal type of cancer and is independent of age, location of the tumour and atrophic gastritis

“…In addition, it is considered that DGCA is not clearly pathogenetically related to AG (Johansen, 1981;Sipponen et al, 1983Jarvi & Lauren, 1951;Lauren, 1965). The present calculations also suggest that AG is not a risk condition of DGCA: the relative risk of DGCA in atrophic gastritis varied around unity in both sexes.…”

“…This alternative may be supported by observations according to which there occur changes in the male-to-female ratio (M/F) of GCA with age (Griffith, 1968), and according to which a high M/F ratio especially occurs in GCA of the intestinal type, i.e., in the tumour type which particularly is related to AG in its morphogenesis (Jiirvi & Lauren. 1951;Lauren, 1965;Sipponen et al, 1983Sipponen et al, , 1984.The objective of the present study was to evaluate the risk of GCA separately in the male and female sexes and to study further whether statistical interactions can be demonstrated between the sex-related risk and the risks that are mediated by age and AG. The analyses were made separately for intestinal (IGCA) and diffuse (DGCA) types of GCA and were based on comparisons of observed and expected frequencies of males and females in a consecutive series of 532 GCA patients.…”

“…This alternative may be supported by observations according to which there occur changes in the male-to-female ratio (M/F) of GCA with age (Griffith, 1968), and according to which a high M/F ratio especially occurs in GCA of the intestinal type, i.e., in the tumour type which particularly is related to AG in its morphogenesis (Jiirvi & Lauren. 1951;Lauren, 1965;Sipponen et al, 1983Sipponen et al, , 1984.…”

General features of gastric carcinomas and comparison of HSP70 and NK cell immunoreactivity with prognostic factors

“…Some biological properties may even resemble carcinomas. 17,23,24 In our study type 3 was the most frequent type (p<0.05). The coexistence of intestinal type carcinomas and type 3 IM in 75% of the cases is in accordance with the literature.…”

“…1,4,17,18 In our series, regardless 265 HSP70 and NK-cells in gastric cancer Vol 8 of the histological type, 90.4% of the cases had varying degrees of chronic atrophic gastritis. Remarkably, in addition to the intestinal type carcinomas, the mucosa adjacent to the diffuse and mixed type carcinomas also showed chronic atrophic gastritis.…”