Intestinal Metaplasia With Colonic‐type Sulphomucins in the Gastric Mucosa; Its Association With Gastric Carcinoma

Abstract

The occurrence of intestinal metaplasia with colonic‐type sulphomucins: (abbreviated: s‐IM or s‐positive IM) in the gastric mucosa was studied in 125 patients with gastric carcinoma (GCA), 62 patients with pernicious anemia (PA), 301 and 183 first‐degree relatives of GCA and PA patients, 406 outpatients and in 358 controls matched from a large population sample. The sulphomucins (s‐mucins) were demonstrated histochemically in endoscopic biopsy specimens by using high iron diamine and Alcian blue (pH 1) methods. The prevalence of s‐IM, especially the strongly s‐positive IM, was significantly higher in GCA patients than in other series or controls of the same age group. Further, s‐IM was significantly more common in PA patients and its prevalence higher in GCA relatives and outpatients than in other series or controls. The occurrence of s‐IM was also age‐dependent and dependent on the extent of IM. It was suggested that the occurrence of s‐IM can be used as a sign of lesions that are more closely associated with GCA than IM is in general.

Utility of subtyping intestinal metaplasia as marker of gastric cancer risk. A review of the evidence

“…Subtyping of IM was done by a combination of morphology and mucins staining. Most of the studies used specimens stained with hematoxylin and eosin (H&E), alcian blue (AB)/periodic acid‐Shiff (PAS) at pH 2.5, and high iron diamine (HID)/AB . One study used also marker enzymes as aminopeptidase and phosphatase.…”

“…A total of 14 cross-sectional [14][15][16][17][18][19][20][21][22][23][24][25][26][27] and ten follow-up studies [28][29][30][31][32][33][34][35][36][37] met all the search criteria. Three cross-sectional studies were excluded because of the lack of a comparison group.…”

“…Most of the studies used specimens stained with hematoxylin and eosin (H&E), alcian blue (AB)/periodic acid-Shiff (PAS) at pH 2.5, and high iron diamine (HID)/ AB. 14,17,26,27,31 One study 27 used also marker enzymes as aminopeptidase and phosphatase. Most of the studies classified IM as type I, II or III, or as complete (type I) or incomplete (type II and III), whereas others 15,19,21,24 classified the IM as type I, type IIa (sialomucin) and type IIb (sulfomucin positive).…”

“…Gonz alez et al significantly higher in GC than in other gastric lesions. [14][15][16][17][18][20][21][22][23][24][25][26][27] In most of the studies, type III IM was more frequently associated with intestinal-type GC than with diffuse type. One study, 19 with only 21 GCs of intestinal type, was the only one without significant differences in the prevalence of incomplete IM between GC cases and controls.…”

Mucin-Type O-Glycosylation in Gastric Carcinogenesis

“…There are distinct types of IM, which have different risks of evolving in the carcinogenic pathway [ 4 , 73 , 74 ]. Regarding histomorphological features, it is possible to define two major types of IM.…”