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. 1991 Oct;32(10):1110–1113. doi: 10.1136/gut.32.10.1110

Detection of an increased incidence of early gastric cancer in patients with intestinal metaplasia type III who are closely followed up.

T Rokkas 1, M I Filipe 1, G E Sladen 1
PMCID: PMC1379368  PMID: 1955163

Abstract

Because early gastric cancer is associated with a much better prognosis than advanced disease, its diagnosis is important. Over a 12 year period (1976-87), a progressive increase in the incidence of early gastric cancer was observed. Twenty four of the 718 (3.3%) consecutive gastric resections for gastric cancer in this period were in patients with early gastric cancer. Six of the 24 were diagnosed in the first six year period (1976-81) and 18 in the second six year period (1982-87) (p less than 0.01). This increase was observed during the prospective phase of the study, when all patients diagnosed on initial biopsy specimen as showing type III intestinal metaplasia underwent follow up endoscopy and biopsy at six to 12 month intervals. Eleven of the 18 with early gastric cancer detected in this period were diagnosed as a direct result of this follow up. We conclude that early gastric cancer can be diagnosed with increasing frequency if patients with type III intestinal metaplasia are closely followed endoscopically.

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Selected References

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  1. Correa P. A human model of gastric carcinogenesis. Cancer Res. 1988 Jul 1;48(13):3554–3560. [PubMed] [Google Scholar]
  2. Devesa S. S., Silverman D. T. Cancer incidence and mortality trends in the United States: 1935-74. J Natl Cancer Inst. 1978 Mar;60(3):545–571. doi: 10.1093/jnci/60.3.545. [DOI] [PubMed] [Google Scholar]
  3. Ectors N., Dixon M. F. The prognostic value of sulphomucin positive intestinal metaplasia in the development of gastric cancer. Histopathology. 1986 Dec;10(12):1271–1277. doi: 10.1111/j.1365-2559.1986.tb02570.x. [DOI] [PubMed] [Google Scholar]
  4. Farini R., Farinati F., Leandro G., Di Mario F., Cecchetto A., Naccarato R. Gastric epithelial dysplasia in relapsing and nonrelapsing gastric ulcer. Am J Gastroenterol. 1982 Nov;77(11):844–853. [PubMed] [Google Scholar]
  5. Fielding J. W., Roginski C., Ellis D. J., Jones B. G., Powell J., Waterhouse J. A., Brookes V. S. Clinicopathological staging of gastric cancer. Br J Surg. 1984 Sep;71(9):677–680. doi: 10.1002/bjs.1800710910. [DOI] [PubMed] [Google Scholar]
  6. Filipe M. I., Potet F., Bogomoletz W. V., Dawson P. A., Fabiani B., Chauveinc P., Fenzy A., Gazzard B., Goldfain D., Zeegen R. Incomplete sulphomucin-secreting intestinal metaplasia for gastric cancer. Preliminary data from a prospective study from three centres. Gut. 1985 Dec;26(12):1319–1326. doi: 10.1136/gut.26.12.1319. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Green P. H., O'Toole K. M., Slonim D., Wang T., Weg A. Increasing incidence and excellent survival of patients with early gastric cancer: experience in a United States medical center. Am J Med. 1988 Nov;85(5):658–661. doi: 10.1016/s0002-9343(88)80238-9. [DOI] [PubMed] [Google Scholar]
  8. Green P. H., O'Toole K. M., Weinberg L. M., Goldfarb J. P. Early gastric cancer. Gastroenterology. 1981 Aug;81(2):247–256. [PubMed] [Google Scholar]
  9. Huang C. B., Xu J., Huang J. F., Meng X. Y. Sulphomucin colonic type intestinal metaplasia and carcinoma in the stomach. A histochemical study of 115 cases obtained by biopsy. Cancer. 1986 Apr 1;57(7):1370–1375. doi: 10.1002/1097-0142(19860401)57:7<1370::aid-cncr2820570721>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  10. Ito Y., Blackstone M. O., Riddell R. H., Kirsner J. B. The endoscopic diagnosis of early gastric cancer. Gastrointest Endosc. 1979 Aug;25(3):96–101. doi: 10.1016/s0016-5107(79)73384-0. [DOI] [PubMed] [Google Scholar]
  11. Kitaoka H., Yoshikawa K., Hirota T., Itabashi M. Surgical treatment of early gastric cancer. Jpn J Clin Oncol. 1984 Jun;14(2):283–293. [PubMed] [Google Scholar]
  12. Ramesar K. C., Sanders D. S., Hopwood D. Limited value of type III intestinal metaplasia in predicting risk of gastric carcinoma. J Clin Pathol. 1987 Nov;40(11):1287–1290. doi: 10.1136/jcp.40.11.1287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rothery G. A., Day D. W. Intestinal metaplasia in endoscopic biopsy specimens of gastric mucosa. J Clin Pathol. 1985 Jun;38(6):613–621. doi: 10.1136/jcp.38.6.613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Sakita T., Oguro Y., Takasu S., Fukutomi H., Miwa T. Observations on the healing of ulcerations in early gastric cancer. The life cycle of the malignant ulcer. Gastroenterology. 1971 May;60(5):835–passim. [PubMed] [Google Scholar]
  15. Silva S., Filipe M. I. Intestinal metaplasia and its variants in the gastric mucosa of Portuguese subjects: a comparative analysis of biopsy and gastrectomy material. Hum Pathol. 1986 Oct;17(10):988–995. doi: 10.1016/s0046-8177(86)80082-x. [DOI] [PubMed] [Google Scholar]
  16. Silva S., Filipe M. I., Pinho A. Variants of intestinal metaplasia in the evolution of chronic atrophic gastritis and gastric ulcer. A follow up study. Gut. 1990 Oct;31(10):1097–1104. doi: 10.1136/gut.31.10.1097. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Sipponen P., Seppälä K., Varis K., Hjelt L., Ihamäki T., Kekki M., Siurala M. Intestinal metaplasia with colonic-type sulphomucins in the gastric mucosa; its association with gastric carcinoma. Acta Pathol Microbiol Scand A. 1980 Jul;88(4):217–224. doi: 10.1111/j.1699-0463.1980.tb02489.x. [DOI] [PubMed] [Google Scholar]
  18. de Dombal F. T., Price A. B., Thompson H., Williams G. T., Morgan A. G., Softley A., Clamp S. E., Unwin B. J. The British Society of Gastroenterology early gastric cancer/dysplasia survey: an interim report. Gut. 1990 Jan;31(1):115–120. doi: 10.1136/gut.31.1.115. [DOI] [PMC free article] [PubMed] [Google Scholar]

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