No abstract

Epidemiological, 2 and morphological3-5 studies have shown that there is an association between intestinal metaplasia and gastric carcinoma, and it has been considered by many to be a possible marker of premalignant change. Intestinal metaplasia is also a common finding in benign disease of the stomach, however, and recent studies have therefore been directed at identifying variants of intestinal metaplasia which may have a more specific association with gastric carcinoma.6-'2On the basis of morphological and histochemical studies several variants of intestinal metaplasia have been described, and these findings have been supported by the results of enzyme histochemistry,'3 14 immunofluorescence,'5 and ultrastructural examination.'6-'8 Although there is some variation in the classification of these subtypes of intestinal metaplasia according to different authors, two main groups are identifiable: complete intestinal metaplasia, which is morphologically similar to epithelium of the small bowel, and incomplete intestinal metaplasia, which shows intermediate features of both gastric and small bowel epithelium. Both groups can be further characterised by the presence Accepted for publication 5 February 1985 or absence of large intestinal enzymes and mucins (o-acylated sialomucins and sulphomucins).Several recent studies show that the presence of sulphated mucins in intestinal metaplasia has a closer association with gastric carcinoma than intestinal metaplasia in general.6'0'2'9 This being the case, its presence in endoscopic biopsy material might serve as an important marker indicating the need for careful follow up of the patient. The aim of this investigation was to determine the prevalence of intestinal metaplasia and its variants in endoscopic biopsy specimens and to assess the significance of sulphated mucins in intestinal metaplasia in relation to different gastric diseases. Material and methodsIn the four year period between January 1980 and December 1983 a total of 1465 upper gastrointestinal endoscopies with gastric biopsy were carried out at the Royal Liverpool Hospital. Of these, 92 were repeat examinations, but for the purposes of the present study biopsies from each endoscopy were treated as an individual case. The histology of 1412 cases was reviewed; in the remaining 53 cases material was unavailable for examination and these were excluded. In each case haematoxylin and eosin 613 on 12 May 2018 by guest. Protected by copyright.