Conchillo J M, Houben G, de Bruïne A, Stockbrügger R
Division of Internal Medicine, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Eur J Cancer Prev. 2001 Aug;10(4):307-12. doi: 10.1097/00008469-200108000-00003.
This retrospective study was performed to assess whether type III intestinal metaplasia is an obligatory precancerous lesion of intestinal-type gastric carcinoma and to determine its possible use as a marker of enhanced cancer risk. From 48 consecutive patients with gastric cancer who underwent a gastrectomy over a 3-year period (mean age 72.0 years; 29 M/19 F), at least two sections from antrum, corpus and tumour-surrounding mucosa were obtained for the examination of presence and subtypes of intestinal metaplasia (IM). It was found that 77.1% of the carcinomas were of the intestinal type and 22.9% of the diffuse type. The intestinal-type was more often found in males (P = 0.01); the mean age at diagnosis in this type was higher than in the diffuse cancer group (P = 0.004). There was a high prevalence of total IM in both the intestinal (75.7%) and diffuse group (88.9%). Type I IM was predominant in antrum and corpus of patients from both groups. Type III IM was only found among patients with intestinal-type carcinoma. However, its prevalence was rather low (26.3%). Therefore the absence of this lesion in patients with other risk factors cannot be used as an argument for lowering the degree of surveillance and its presence seems to be sufficient indication for long-term follow-up.
本回顾性研究旨在评估III型肠化生是否为肠型胃癌的必经癌前病变，并确定其作为癌症风险增加标志物的潜在用途。在3年期间对48例连续接受胃切除术的胃癌患者（平均年龄72.0岁；男性29例/女性19例）进行研究，从胃窦、胃体和肿瘤周围黏膜获取至少两片组织，以检查肠化生（IM）的存在情况和亚型。结果发现，77.1%的癌为肠型，22.9%为弥漫型。肠型在男性中更常见（P = 0.01）；该型的诊断平均年龄高于弥漫癌组（P = 0.004）。肠型组（75.7%）和弥漫型组（88.9%）中总IM的患病率均较高。两组患者胃窦和胃体中I型IM占主导。III型IM仅在肠型癌患者中发现。然而，其患病率相当低（26.3%）。因此，不能以其他风险因素患者中不存在该病变为由降低监测程度，而其存在似乎是长期随访的充分指征。
