INTESTINAL METAPLASIA TYPES AND THE RISK OF GASTRIC-CANCER - A COHORTSTUDY IN SLOVENIA

Between 1967 and 1976, 1,525 Slovenian patients with a histological di agnosis of intestinal metaplasia (IM) were classified according to sub type of IM based on morphology and mucin staining; 518 cases were diag nosed with type I, 197 with type II and 275 with type III, but in 291 the diagnosis of Im was not confirmed. Patients who had developed canc er or died up to 1986 were identified by record linkage at the Sloveni a Cancer Registry and the Central Population Registry in Slovenia. A t otal of 34 incidents cases of gastric cancer occurring at least 6 mont hs after the diagnosis of IM were identified. The standardised inciden ce ratio (SIR) for stomach cancer was 2.23 in the whole cohort. It was highest for IM type III, followed by type II and IM-unconfirmed, but not increased for type I. The relative risk (RR) of developing gastric cancer based on Cox's proportional hazards model was 2.14 for type II and 4.58 for type III, compared with type I. The RR was especially in creased for a subgroup of type III secreting sulphomucins in their gob let cells in comparison with types I-II negative to sulphomucins. Our results confirm that subtyping of IM is useful for identifying individ uals at high risk for gastric cancer. (C) 1994 Wiley-Liss, Inc.