INTESTINAL METAPLASIA IN GASTRIC MALIGNANCY - A COMPARISON BETWEEN CARCINOMA AND LYMPHOMA

Objectives Intestinal metaplasia is associated with gastric carcinomas , in particular intestinal-type carcinomas. According to the literatur e, intestinal metaplasia, especially the sulphomucin-rich incomplete t ype (type IIb or III) can be considered as a precancerous lesion. Inte stinal metaplasia is not uncommon in gastric lymphomas, and the purpos e of this study was to determine its prevalence and extent, its differ ent subtypes and the distribution of sulphomucin and to compare these findings with those in gastric carcinomas. Design The prevalence and g rade of intestinal metaplasia were investigated in surgical specimens from 160 patients with gastric carcinoma (102) [intestinal type (69), diffuse type (33)] and gastric lymphoma (58) [marginal zone cell (29), diffuse large cell (29)], Intestinal metaplasia is analysed by specif ic mucin stains. Methods Intestinal metaplasia was described according to the Updated Sydney system. Using periodic acid-Schiff Alcian Blue pH 2.5 and high iron-diamine/Alcian Blue staining, the intestinal meta plasia was classified (Jass classification) and its sulphomucin conten t was determined. Results The prevalence and extent of intestinal meta plasia are significantly higher in intestinal-type carcinomas than all other gastric malignancies. Subtyping of intestinal metaplasia is ind ependent of the different types of gastric neoplasia, High sulphomucin positivity in the metaplastic epithelium is only seen in intestinal-t ype carcinomas, although in a small number of cases (21.5%). Conclusio n Prevalence, extent and sulphomucin content of intestinal metaplasia are significantly higher in intestinal-type gastric carcinoma compared to diffuse-type carcinoma, marginal zone cell and diffuse large cell lymphomas in the stomach. (C) 1998 Lippincott-Raven Publishers.