Yamakawa H
Gan No Rinsho. 1986 May;32(6):681-91.
The natural history of intestinal metaplasia of gastric mucosa was studied in 414 rural inhabitants; 213 males and 201 females, from Chokai Village in Akita Prefecture in the northeast part of Japan's main island of Honshu. The subjects were examined by a mobile gastrointestinal unit and were biopsied at eight standard points of the gastric mucosa. The specimens were examined histologically, and were divided into 4 grades. The metaplasia index (MI) was adopted as a quantitative expression of the severity of intestinal metaplasia of the gastric mucosa. The MI of the three areas of the village were compared with the different incidences of stomach cancer. The following results were obtained: in gastric mucosa. The average values of the MI among the male population were highest at the high-risk area, low at the low-risk area and intermediate at the moderate-risk area of gastric cancer. Whereas, the values among females showed no differences in these three areas. The risks for stomach cancer also were almost equal. These phenomena would show a very close relationship between intestinal metaplasia and the incidence of stomach cancer. There was a positive correlation (p less than 0.01) between MI and the detection rates of stomach cancer by a mass screening examination in the areas. Study of food intake and especially the salt consumption among the three areas showed a close relationship with intestinal metaplasia. Certain foods seemed to relate to intestinal metaplasia and eventually to stomach cancer. The conclusion was drawn that the development of intestinal metaplasia could be prevented by the improvement of environmental factors especially by that of food intake. Thus, the reduction in the incidence of stomach cancer also would be possible.
对日本本州岛东北部秋田县鸟海村的414名农村居民（213名男性和201名女性）的胃黏膜肠化生自然史进行了研究。研究对象由一个流动胃肠检查小组进行检查，并在胃黏膜的八个标准点取活检组织。对标本进行组织学检查，并分为4级。采用化生指数（MI）作为胃黏膜肠化生严重程度的定量指标。将该村三个区域的MI与不同的胃癌发病率进行比较。结果如下：在胃黏膜方面。男性人群中MI的平均值在胃癌高风险区域最高，在低风险区域最低，在中风险区域居中。而女性在这三个区域的值没有差异。患胃癌的风险也几乎相等。这些现象表明肠化生与胃癌发病率之间存在非常密切的关系。在这些区域，MI与大规模筛查检查中胃癌的检出率之间存在正相关（p<0.01）。对这三个区域的食物摄入，尤其是盐摄入量的研究表明，其与肠化生密切相关。某些食物似乎与肠化生有关，并最终与胃癌有关。得出的结论是，通过改善环境因素，尤其是食物摄入，可以预防肠化生的发展。因此，降低胃癌发病率也是可能的。
