Gastric carcinomas of intestinal type concur with distant changes in the gastric mucosa. A multicenter study in the Atlantic basin.

Population studies in the Pacific Basin showed that gastric carcinomas of intestinal type often concur with distant mucosal changes (DMCs). In the present work, the presence of DMCs was investigated in populations dwelling in the Atlantic Basin. A total of 1737 gastrectomy specimens were reviewed: 627 in New York, 435 in Reykjavik, 198 in Buenos Aires, 186 in Florence, 174 in London and the remaining 117 in Stockholm. A total of 17,282 sections were carefully scrutinized. The following DMCs were investigated: intramucosal glandular cysts, gastric cells with ciliated metaplasia, with large or small mucus negative vacuoles, and extensive intestinal metaplasia (IM). The highest frequencies of DMCs were found in Florence for specimens with intestinal type carcinoma: 41.3% had intramucosal cysts, 22.4% had cells with ciliated metaplasia, 12.9% cells with large vacuoles, and 50.9% had high IM. The highest frequency of gastric cells with small vacuoles was recorded in New York (9.1%), also in specimens with intestinal type carcinoma. Significantly lower DMCs percentages were found in specimens with carcinomas of diffuse type, and miscellaneous gastric diseases. The occurrence of DMCs was not influenced to a significant degree by the number of sections available per gastrectomy. Since environmental factors trigger the evolution of intestinal type carcinomas and as DMCs also occurred in specimens without carcinoma-although at a significantly lower rate--it is conceivable that DMCs are also evoked by environmental factors (before a gastric carcinoma ensues). DMCs were found in specimens having intestinal carcinomas either in the cardia, the corpus or the antrum. Thus, DMCs seem to provide the adequate "soil" for the development of gastric carcinomas of intestinal type, independently of the future localization of that tumor in the stomach.

[Intestinal metaplasia of the stomach. Frequency in a study of endoscopic biopsies]. / Metaplasia intestinal gástrica. Frecuencia en un estudio de biopsias endoscópicas.

The histologic sections of gastric endoscopic biopsies performed during a 4 years period were reexamined. Those cases in which the whole mucosa was not included in the biopsy and those of cancer or peptic ulcer in which another biopsy of normal mucosa outside of the lesion was not obtained, were ruled out. The presence of intestinal metaplasia (IM) and gastritis was investigated. Gastritis was classified according to Whitehead. No attempt was made to grade IM. The relationship of the frequency of IM with age, severity of gastritis, cancer, peptic ulcer and different areas of the stomach was studied. Cases without cancer or peptic ulcer were used as controls. IM was present in 67 (32.1%) out of 209 cases that were reviewed. A significant difference in the frequency of IM was found between those cases below 40 years and those with 41 or more. The difference was not significant when the following decades were considered (tables 1, 2 and 3). Either was there any significant difference of frequency between sexes. According to our criteria for the selection of cases only 16 carcinomas were included in this series. IM was observed in 50% of the cases. Fifteen patients had more than 50 years. There was a considerable difference in the percentage of IM between this group and that of the controls with 50 or more years, nevertheless this difference was not significant, probably because of the small number of cases, (table 6). IM was found in 48.8% of 43 cases with peptic ulcer.(ABSTRACT TRUNCATED AT 250 WORDS)

Metaplasia intestinal gástrica. Frecuencia en un estudio de biopsias endoscópicas. / [Intestinal metaplasia of the stomach. Frequency in a study of endoscopic biopsies]

The histologic sections of gastric endoscopic biopsies performed during a 4 years period were reexamined. Those cases in which the whole mucosa was not included in the biopsy and those of cancer or peptic ulcer in which another biopsy of normal mucosa outside of the lesion was not obtained, were ruled out. The presence of intestinal metaplasia (IM) and gastritis was investigated. Gastritis was classified according to Whitehead. No attempt was made to grade IM. The relationship of the frequency of IM with age, severity of gastritis, cancer, peptic ulcer and different areas of the stomach was studied. Cases without cancer or peptic ulcer were used as controls. IM was present in 67 (32.1

) out of 209 cases that were reviewed. A significant difference in the frequency of IM was found between those cases below 40 years and those with 41 or more. The difference was not significant when the following decades were considered (tables 1, 2 and 3). Either was there any significant difference of frequency between sexes. According to our criteria for the selection of cases only 16 carcinomas were included in this series. IM was observed in 50

of the cases. Fifteen patients had more than 50 years. There was a considerable difference in the percentage of IM between this group and that of the controls with 50 or more years, nevertheless this difference was not significant, probably because of the small number of cases, (table 6). IM was found in 48.8

of 43 cases with peptic ulcer.(ABSTRACT TRUNCATED AT 250 WORDS)