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Endoscopic studies of intestinal metaplasia of the stomach

Endoscopic studies of intestinal metaplasia of the stomach

Journal of Kyoto Prefectural University of Medicine 91(3): 185-202

With the development of magnifying fiberscope and the methylene blue (MB) staining method, intestinal metaplasia in the [human] gastric mucosa could be diagnosed by endoscopic examination. Findings were confirmed by histological examination of biopsy specimens under endoscopic direct vision. The occurrence of, evolution of and relation to various gastro-duodenal diseases of intestinal metaplasia were investigated. The frequency of intestinal metaplasia was greatly increased in patients > 40 yr old, and the MB staining area tended to spread with aging. Intestinal metaplasia was prevalent and severe in stomachs with gastric cancer and gastric polyp but was slight and localized in gastric erosion, gastritis erosiva and duodenal ulcer. The MB staining type was classified as depressed, flat or granular types. Most depressed types were seen in the younger generation in localized intestinalized mucosa of the stomach and in stomachs with gastric erosion, gastritis erosiva and duodenal ulcer. Granular type was seen in the elder generation with extensive intestinalized mucosa of the stomach, gastric cancer and gastric polyp. Flat type was seen with the same frequency in various ages and with various diseases. Follow-up observations using the MB staining method proved that the staining type developed from depressed type to flat type and from flat type to granular type. Some intestinal metaplasia occurred in regenerating mucosa of gastric erosion. The early stage of intestinal metaplasia rarely disappeared. Differentiated adenocarcinoma of early gastric cancer accompanied extensive intestinal metaplasia and was surrounded by the intestinalized mucosa. There was a close correlation between differentiated adenocarcinoma and intestinal metaplasia of the stomach.

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Accession: 005359625

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