Rubio C A, Kato Y, Sugano H, Kitagawa T
Anticancer Res. 1985 Jul-Aug;5(4):435-40.
A novel method of quantitation of the extent of intestinal metaplasia (IM) was applied to 50 resected stomachs from Japanese subjects; 25 with peptic gastric ulcer, 25 with incipient adenocarcinoma. The total length of the IM was significantly larger (p less than 0.05) in incipient adenocarcinomas than in peptic ulcers; the total length of the gastric mucosa analyzed being similar in the two groups. The intestinal metaplasia index (IMI; i.e. the ratio between IM and the length of the gastric mucosa analyzed) in incipient adenocarcinomas was significantly higher (p less than 0.05) than in gastric ulcers. In incipient adenocarcinomas, the IMI decreased significantly (p. less than 0.001) from lesser towards greater curvature. In peptic ulcers, the decrease was less abrupt. In 12 of the 25 specimens, the incipient adenocarcinoma was classified as intestinal type, and in the remaining 13 specimens as diffuse type. The total length of the IM was significantly larger (p less than 0.01) in specimens with intestinal type adenocarcinoma than in specimens with diffuse type; the total length of the gastric mucosa investigated being similar in the two groups. The IMI was significantly higher (p less than 0.01) in specimens containing intestinal type adenocarcinoma as compared to those with diffuse type adenocarcinoma. This was valid for the lesser curvature, for the mucosa adjacent to the lesser curvature, and for the mucosa by the greater curvature. From the results, it is apparent that intestinal metaplasia is a widely occurring phenomenon not only in specimens with intestinal type incipient adenocarcinoma or with diffuse type incipient adenocarcinoma, but also with benign peptic ulcer. The difference resides in that the metaplastic mucosa is more universally distributed in specimens with incipient intestinal adenocarcinomas (provided that longitudinal mucosal areas are considered in the comparison). The quantitative method herein reported will be applied in the future to compare the extent and distribution of intestinal metaplasia in gastric specimens from various geographical regions having disparate incidences of gastric ulcers and carcinomas.
一种定量检测肠化生（IM）程度的新方法应用于50例来自日本受试者的切除胃标本；其中25例患有消化性胃溃疡，25例患有早期腺癌。早期腺癌中IM的总长度显著大于消化性溃疡（p<0.05）；两组分析的胃黏膜总长度相似。早期腺癌的肠化生指数（IMI，即IM与分析的胃黏膜长度之比）显著高于胃溃疡（p<0.05）。在早期腺癌中，IMI从胃小弯向胃大弯显著降低（p<0.001）。在消化性溃疡中，这种降低不那么明显。25个标本中有12个的早期腺癌被分类为肠型，其余13个标本为弥漫型。肠型腺癌标本中IM的总长度显著大于弥漫型标本（p<0.01）；两组研究的胃黏膜总长度相似。与弥漫型腺癌标本相比，含有肠型腺癌的标本中IMI显著更高（p<0.01）。这在胃小弯、与胃小弯相邻的黏膜以及胃大弯处的黏膜中均成立。从结果可以明显看出，肠化生不仅在肠型早期腺癌或弥漫型早期腺癌标本中广泛存在，在良性消化性溃疡中也广泛存在。不同之处在于，在早期肠腺癌标本中，化生黏膜分布更为普遍（前提是在比较中考虑纵向黏膜区域）。本文报道的定量方法未来将用于比较来自胃溃疡和癌症发病率不同的各个地理区域的胃标本中肠化生的程度和分布。
