Incomplete sulphomucin-secreting intestinal metaplasia for gastric cancer. Preliminary data from a prospective study from three centres.

Abstract

A prospective study on gastric biopsies with follow up of patients was needed to assess the incidence and distribution of intestinal metaplasia

CDX2 expression is progressively decreased in human gastric intestinal metaplasia, dysplasia and cancer

“…4 IM in the stomach, a key event in gastric carcinogenesis, is the replacement of gastric mucosa by an epithelium that histologically resembles intestinal mucosa. However, IM is present in about 20% of all gastric biopsies 5 and only a minority will progress to gastric cancer. IM is also present in the antrum with duodenal ulcer, which is associated with lower risk of gastric cancer.…”

A Novel Method for Detecting Single Glandular Intestinal Metaplasia in the Mucosal Surface of the Fixed Stomach Using Methylene Blue

“…This is the incomplete type of intestinal metaplasia, or intestinal metaplasia subtype IIa and subtype IIb. [2][3][4][5][6][7][10][11][12] Fifty regions that did not contain islands were also examined histologically.…”

“…1) An association between intestinal metaplasia and intestinal-type gastric cancer has been reported both epidemiologically and histologically. [2][3][4][5][6][7] There are three possible explanations for this 2,3) :(1) intestinal metaplasia is a direct precursor lesion of the cancer; (2) intestinal metaplasia creates a favorable milieu for carcinogenesis, perhaps by raising the pH of gastric juice, and improving the growth conditions for bacteria that produce carcinogens; or (3) intestinal metaplasia may simply be a paraneoplastic lesion caused by the same agents that gave rise to the cancer. 2) We previously reported that almost all intestinal metaplastic mucosa detected by the Tes-tape method, 8) in samples of φ3 mm in diameter, contains intestinal metaplastic glands of polyclonal origin.…”

“…Subtype IIb intestinal metaplasia, which is a variety of the incomplete type and is associated with sulfomucins, in particular, is known to accompany the intestinal type of gastric cancer. [4][5][6][7][10][11][12] Intestinal metaplasia glands are reported to arise initially in the proliferating zone at the neck of normal glands.14) Once cells of the intestinal type arise, they replace normal glandular cell types throughout the gland.13) We previously reported that about half of intestinal metaplasia glands are polyclonal in origin even though they arise in the antrum, which is originally covered with pyloric glands that are 95% monoclonal.9) However, a polyclonal cell population cannot arise from a monoclonal cell population without contributions from other cell lineages. There must be ways for intestinal metaplasia glands to develop other than those that have been reported.…”

“…Subtype IIb intestinal metaplasia, which is a variety of the incomplete type and is associated with sulfomucins, in particular, is known to accompany the intestinal type of gastric cancer. [4][5][6][7][10][11][12] Intestinal metaplasia glands are reported to arise initially in the proliferating zone at the neck of normal glands. 14) Once cells of the intestinal type arise, they replace normal glandular cell types throughout the gland.…”