Intestinal Metaplasia and Gastric Carcinoma

Aitchison, Michael (1990) Intestinal Metaplasia and Gastric Carcinoma. MD thesis, University of Glasgow.

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Abstract

Previous studies have suggested that gastric carcinogenesis is a multistage process involving first gastritis, then intestinal metaplasia, dysplasia of increasing severity and finally carcinoma. The exact role of intestinal metaplasia in the histogenesis of gastric carcinoma has been the subject of much debate. Recent work has identified an intestinal metaplasia variant (Type IIb) which appears to be significantly associated with a particular histological type of gastric carcinoma. The aim of the studies carried out in the preparation of this thesis was to investigate the histogenesis of gastric carcinoma with particular reference to the role of intestinal metaplasia in this process. The material studied was a series of gastrectomy specimens resected for both benign and malignant disease. In addition fetal stomachs, endoscopic biopsy material from a group of patients who had undergone gastric surgery for peptic ulcer disease, and an animal experimental model of gastric carcinogensis were studied to examine specific aspects of the carcinogenetic sequence. The methods utilised in the studies involved histological assessment, mucin and immunocytochemical techniques and cell kinetic analysis. The results of the histological investigation indicate that the presence and amount of intestinal metaplasia in the gastrectomy material is related to variables such as age and inflammatory change rather than the presence of a tumour. The results also demonstrate that the presence of the type lIb variant is related to age, inflammation and ulceration within the gastrectomy rather than the presence of any particular tumour sub-type. The results of the mucin and immunocytochemical studies identified a series of phenotypic changes in the stages of gastric carcinogenesis which did not lend support to the role of intestinal metaplasia in the histogenesis of gastric carcinoma. The cell kinetic study documented the changes in cellular proliferation that occur in the stages of gastric carcinogenesis. A series of cell kinetic abnormalities in the gastric mucosa of patients who had undergone gastric surgery for benign disease were identified. These abnormalities were shown to be related to alkaline reflux gastritis. It is suggested that intestinal metaplasia and its variants do not represent a premalignant stage in the histogenesis of gastric carcinoma.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine, Pathology
Date of Award: 1990
Depositing User: Enlighten Team
Unique ID: glathesis:1990-78062
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 30 Jan 2020 15:42
Last Modified: 30 Jan 2020 15:42
URI: http://theses.gla.ac.uk/id/eprint/78062

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