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Gastric and intestinal mixed and solely intestinal types of intestinal metaplasia in the human stomach
Author(s) -
Inada Kenichi,
Nakanishi Hayao,
Fujimitsu Yasunobu,
Shimizu Nobuyuki,
Ichinose Masao,
Miki Kazumasa,
Nakamura Shigeo,
Tatematsu Masae
Publication year - 1997
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.1997.tb03714.x
Subject(s) - intestinal metaplasia , goblet cell , immunohistochemistry , foveolar cell , staining , stomach , pathology , medicine , gastroenterology , biology , gastric mucosa , epithelium
To generate a novel understanding of Intestinal metaplasia (IM) on the basis of cellular differentiation status, a total of 132 gastric surgical specimens were studied using gastric and small intestinal cell markers by much histochemical and Immunohistochemical techniques. The cases were divided into two types: (i) gastric and intestinal (GI) mixed type; and (ii) solely intestinal (I) type, with the reference to the presence of gastric and/or intestinal cell markers. The GI mixed type was subdivided into six subtypes: (i) a subtype consisting of surface mucous (Su), pyloric gland (Py), Intestinal absorptive (Ab), and goblet (Go) cells, but lacking Paneth (Pa) cells, GI(Pa‐); (ii) a GI(Pa‐) subtype without Py cells, GI(Py‐, Pa‐); (iii) a GI(Pa‐) subtype without Su cells, GI(Su‐, Pa‐); (iv) a GI(Su‐, Pa‐) subtype with Pa cells, GI(Su‐, Pa+); (v) a Gi(Pa‐) subtype with Pa cells, GI(Pa+); and (vi) a GI(Pa+) subtype without Py cells, GI(–, Pa+).The I type was subdivided Into: (I) a subtype consisting of cells with Ab and Go cells, I(Pa‐); and (ii) a I(Pa‐) subtype with Paneth cells, I(Pa+). The GI mixed subtypes, except for the GI(Py‐, Pa‐) and GI(Py‐, Pa+), were characterized by Intestinalized gastric plts connected with underlying pyloric glands. Immunohistochemical staining of proliferating cell nuclear antigen (PCNA) revealed a common prolifemtive cell zone between the two. The GI mixed type, especially the GI(Pa‐) subtype, predominated in the pyloric mucose, while the I type was most frequent In the fundle region, suggesting that the pathogenesis of IM differs between these two locations. The results of the study confirm that IM is an abnormal and unstable differentiation status between the stomach and small Intestine.