Intestinal metaplasia and gastric carcinoma. A histochemical and immunohistochemical study.

This article sums up the histochemical and immunohistochemical study of 55 cases of gastric carcinoma and 21 controls with benign gastric lesions. The results showed most of the adjacent mucosa of gastric carcinoma developed incomplete type intestinal metaplasia (IM). The percentage of Type IIb (ie, secreting sulphomucin) reached 72.5%. In most cases, high iron diamine (HID) rose in cancerous tissue and concomitantly in the IM epithelium of the adjacent gastric carcinoma. The phenomena of separation condition of HID+ in cancerous tissue, HID- in IM epithelium surrounding carcinoma, or HID- in cancerous cell but HID+ in IM of the surrounding epithelium of carcinoma, were much fewer. The two kinds of mucin antigen distribution were observed simultaneously. In the control and gastric carcinoma groups, neither large intestinal mucin antigen (LIMA) nor small intestinal mucin antigen (SIMA) could be detected in the normal epithelium of gastric mucosa. SIMA was mainly found in the goblet cells of IM and the mucous cells of columnar epithelium, while LIMA was mainly present in the columnar cells, in luminal border and/or in goblet cells. LIMA in the carcinoma group is apparently higher than that in the controls. The percentage of LIMA+ in the IM epithelium of adjacent gastric carcinoma and that in carcinoma cells were also raised in most cases. All these demonstrated a close relationship between IM and gastric carcinoma. Our results also showed that not only HID+, but also LIMA+ may represent a precancerous lesion in gastric carcinoma.