Endoscopic Analysis Of Intestinal Metaplasia And Intestinal Type Of Gastric Cancer

Background Intestinal metaplasia (IM) was a common pathologic chang in chronic gastritis and regarded as a important precancerous lesions of intestinal type of gastric cancer. A strong association has been described between chronic infection with Helicobacter pylori and intestinal metaplasia in previous studys. The gastric mucosa infected by Helicobacter pylori has higher opportunity for intestinal metaplasia arises , on the contrary the gastric mucosa with IM in favor of HP planted in it. Glandular atrophy and intestinal metaplasia both were precancerous lesions, generally IM was appeared accompany with glandular atrophy and their degrees were similar. Intestinal type of gastric cancer was corned from intestinal epidermis and associated with IM. IM was regarded as a important stage in the pathogenesis of intestinal type of gastric cancer, but has no direct evidences in it. Many author regarded IM as paracancerous but not precancerous. Objective The objective of this study was to study the relationship between the H.pylori infection and IM , the relationship between degree of IM and glandular atrophy. At the same time , this study was also investigate the relationship between IM and intestinal type of gastric cancer in age, location and sex.Methods A total of 14799 patients who undergoing upper endoscopy from 1997 to 2002 years, atrophy and metaplasia were graded according to the updated Sydney System, the diagnose of intestinal type of gastric cancer was according to the pathologic standards of whole country.Result The detectable rates of moderate and severe degree of IM in Helicobacter pylori-positive patients were significantly higher than gastric mucosa without IM or company with mild degree of IM (p<0.01) . IM appeared accompany with glandular atrophy and correlated to the degree of atrophy. Significant difference was observed in average age between IM and intestinal type of gastric cancer (P<0.01). The average age of intestinal type of gastric cancer in corpus was the lowest age in intestinal type of gastric cancer (p<0.01). There were no significant difference between the average age in gastric antrum, gastric body, gastric fundus and gastric cardia (p>0.05).. Significant different of sex in intestinal type of gastric cancer was obtained(P<0.01), but not in IM(P>0.05).Conclusion There were strong association between the infection Helicobacter pylori and intestinal metaplasia. The degree of IM correlated to the atrophy . Intestinal type of gastric cancer appeared earlier than IM, but they were no different in age , location and sex. Consequently, IM probably has association with intestinal type of gastric cancer, but it was not a determinate effect.