Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1985 Jun;38(6):613–621. doi: 10.1136/jcp.38.6.613

Intestinal metaplasia in endoscopic biopsy specimens of gastric mucosa.

G A Rothery, D W Day
PMCID: PMC499258  PMID: 2409115

Abstract

A total of 1412 consecutive cases of endoscopic gastric biopsy, carried out over a four year period, were reviewed and specimens were examined histochemically to determine the prevalence of intestinal metaplasia and its variants. Three types were characterised: complete intestinal metaplasia and two classes of incomplete intestinal metaplasia (type IIa and type IIb) depending on the absence or presence, respectively, of sulphomucins within mucin secreting columnar cells. Type IIb intestinal metaplasia was significantly more common in patients with gastric carcinoma (p less than 0.001) and in those with dysplasia (p less than 0.001) than in patients with benign gastric pathology. No such association was found with either type I or type IIa intestinal metaplasia. In addition to those present in the columnar cells of type IIb intestinal metaplasia, sulphomucins were also commonly found in goblet cells of all three types of metaplasia. The presence of sulphomucins in goblet cells, however, was not significantly associated with gastric carcinoma or dysplasia. The significance of the different types of intestinal metaplasia in relation to the pathological findings is discussed.

Full text

PDF
617

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Correa P., Cuello C., Duque E. Carcinoma and intestinal metaplasia of the stomach in Colombian migrants. J Natl Cancer Inst. 1970 Feb;44(2):297–306. [PubMed] [Google Scholar]
  2. Gad A. A histochemical study of human alimentary tract mucosubstances in health and disease. I. Normal and tumours. Br J Cancer. 1969 Mar;23(1):52–63. doi: 10.1038/bjc.1969.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Goldman H., Ming S. C. Fine structure of intestinal metaplasia and adenocarcinoma of the human stomach. Lab Invest. 1968 Feb;18(2):203–210. [PubMed] [Google Scholar]
  4. Goldman H., Ming S. C. Mucins in normal and neoplastic gastrointestinal epithelium. Histochemical distribution. Arch Pathol. 1968 Jun;85(6):580–586. [PubMed] [Google Scholar]
  5. Heilmann K. L., Höpker W. W. Loss of differentiation in intestinal metaplasia in cancerous stomachs. A comparative morphologic study. Pathol Res Pract. 1979 Jan;164(3):249–258. doi: 10.1016/S0344-0338(79)80047-3. [DOI] [PubMed] [Google Scholar]
  6. Iida F., Kusama J. Gastric carcinoma and intestinal metaplasia. Significance of types of intestinal metaplasia upon development of gastric carcinoma. Cancer. 1982 Dec 15;50(12):2854–2858. doi: 10.1002/1097-0142(19821215)50:12<2854::aid-cncr2820501227>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  7. Imai T., Kubo T., Watanabe H. Chronic gastritis in Japanese with reference to high incidence of gastric carcinoma. J Natl Cancer Inst. 1971 Jul;47(1):179–195. [PubMed] [Google Scholar]
  8. Jass J. R., Filipe M. I. A variant of intestinal metaplasia associated with gastric carcinoma: a histochemical study. Histopathology. 1979 May;3(3):191–199. doi: 10.1111/j.1365-2559.1979.tb02996.x. [DOI] [PubMed] [Google Scholar]
  9. Jass J. R., Filipe M. I. Sulphomucins and precancerous lesions of the human stomach. Histopathology. 1980 May;4(3):271–279. doi: 10.1111/j.1365-2559.1980.tb02921.x. [DOI] [PubMed] [Google Scholar]
  10. Jass J. R. Role of intestinal metaplasia in the histogenesis of gastric carcinoma. J Clin Pathol. 1980 Sep;33(9):801–810. doi: 10.1136/jcp.33.9.801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kawachi T., Kurisu M., Numanyu N., Sasajima K., Sano T. Precancerous changes in the stomach. Cancer Res. 1976 Jul;36(7 Pt 2):2673–2677. [PubMed] [Google Scholar]
  12. LAUREN P. THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION. Acta Pathol Microbiol Scand. 1965;64:31–49. doi: 10.1111/apm.1965.64.1.31. [DOI] [PubMed] [Google Scholar]
  13. Lei D. N., Yu J. Y. Types of mucosal metaplasia in relation to the histogenesis of gastric carcinoma. Arch Pathol Lab Med. 1984 Mar;108(3):220–224. [PubMed] [Google Scholar]
  14. Lev R. The mucin histochemistry of normal and neoplastic gastric mucosa. Lab Invest. 1965 Dec;14(12):2080–2100. [PubMed] [Google Scholar]
  15. MORSON B. C. Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa. Br J Cancer. 1955 Sep;9(3):377–385. doi: 10.1038/bjc.1955.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. MORSON B. C. Intestinal metaplasia of the gastric mucosa. Br J Cancer. 1955 Sep;9(3):365–376. doi: 10.1038/bjc.1955.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ma J., De Boer W. G., Nayman J. Intestinal mucinous substances in gastric intestinal metaplasia and carcinoma studied by immunofluorescence. Cancer. 1982 Apr 15;49(8):1664–1667. doi: 10.1002/1097-0142(19820415)49:8<1664::aid-cncr2820490822>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  18. Ming S. C., Goldman H., Freiman D. G. Intestinal metaplasia and histogenesis of carcinoma in human stomach. Light and electron microscopic study. Cancer. 1967 Sep;20(9):1418–1429. doi: 10.1002/1097-0142(196709)20:9<1418::aid-cncr2820200908>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  19. Montero C., Segura D. I. Retrospective histochemical study of mucosubstances in adenocarcinomas of the gastrointestinal tract. Histopathology. 1980 May;4(3):281–291. doi: 10.1111/j.1365-2559.1980.tb02922.x. [DOI] [PubMed] [Google Scholar]
  20. SPICER S. S. DIAMINE METHODS FOR DIFFERENTIALING MUCOSUBSTANCES HISTOCHEMICALLY. J Histochem Cytochem. 1965 Mar;13:211–234. doi: 10.1177/13.3.211. [DOI] [PubMed] [Google Scholar]
  21. Segura D. I., Montero C. Histochemical characterization of different types of intestinal metaplasia in gastric mucosa. Cancer. 1983 Aug 1;52(3):498–503. doi: 10.1002/1097-0142(19830801)52:3<498::aid-cncr2820520320>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  22. Sipponen P., Kekki M., Siurala M. Age-related trends of gastritis and intestinal metaplasia in gastric carcinoma patients and in controls representing the population at large. Br J Cancer. 1984 Apr;49(4):521–530. doi: 10.1038/bjc.1984.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. 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]
  24. Stemmermann G. N., Hayashi T. Intestinal metaplasia of the gastric mucosa: a gross and microscopic study of its distribution in various disease states. J Natl Cancer Inst. 1968 Sep;41(3):627–634. [PubMed] [Google Scholar]
  25. Stockton M., McColl I. Comparative electron microscopic features of normal intermediate and metaplastic pyloric epithelium. Histopathology. 1983 Nov;7(6):859–871. doi: 10.1111/j.1365-2559.1983.tb02301.x. [DOI] [PubMed] [Google Scholar]
  26. Tarpila S., Telkkä A., Siurala M. Ultrastructure of various metaplasias of the stomach. Acta Pathol Microbiol Scand. 1969;77(2):187–195. doi: 10.1111/j.1699-0463.1969.tb04223.x. [DOI] [PubMed] [Google Scholar]
  27. Teglbjaerg P. S., Nielsen H. O. "Small intestinal type" and "colonic type" intestinal metaplasia of the human stomach, and their relationship to the histogenetic types of gastric adenocarcinoma. Acta Pathol Microbiol Scand A. 1978 Sep;86A(5):351–355. doi: 10.1111/j.1699-0463.1978.tb02055.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES