Which intestinal metapasia is closer with gastric cancer? Simple or atypical?

February 9, 2010

The classification of intestinal metapasia (IM) is confusing. A research group in China observed IM in gastric biopsies and divided IM into simple IM (SIM) and atypical IM (AIM). By detecting three tumor-associated proteins, p53, c-erbB-2 and Ki67, in IM and gastric cancer, they compared two types of classification in intestinal metaplasia. They found that AIM may have a much more close relationship with gastric cancer.

Gastric cancer remains a significant problem globally. The relationship between intestinal metaplasia (IM) and gastric cancer has always been controversial. Generally IM is divided into subtypes on the basis of histochemical characteristics; however, this classification is confusing. A new classification of IM is needed in order to follow up patients selectively. A research team led by Prof Zhang of the Department of Pathology, Qilu Hospital of Shandong University first proposed the classification of IM into SIM and AIM. The research project has won a Scientific Progress Award from the Board of Education, Shandong Province, China.

A research article to be published in January 21, 2010 in the lies in the novel classification of IM where IM is divided into simple IM (SIM) and atypical IM (AIM). And the data from the research indicated that AIM may be a precancerous lesion which could be a helpful indicator in the surveillance of patients clinically.

The authors regarded SIM as response to stimuli caused by the changing environment, while AIM may have malignant transformation and could be regarded as preneoplastic lesions.

The study provides important new data about the potential risk of in patients with intestinal metaplasia. However, it would be important in the future to investigate the expression of p53 and/or Her2Neu in a prospective study in patients with IM, to confirm that only patients with p53/Her2Neu expression in the IM have actually a higher risk for gastric cancers.

More information: Zheng Y, Wang L, Zhang JP, Yang JY, Zhao ZM, Zhang XY. Expression of p53, c-erbB-2 and Ki67 in intestinal metaplasia and gastric carcinoma. World J Gastroenterol 2010; 16(3): 339-344, www.wjgnet.com/1007-9327/16/339.asp

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