TITLE

Clinicopathological study of background gastric mucosa during long-term conservative maintenance therapy for intractable peptic ulcer

AUTHOR(S)
Nimura, Hiroshi; Takayama, Sumio; Nimura, H; Takayama, S
PUB. DATE
February 1999
SOURCE
Journal of Gastroenterology;1999, Vol. 34 Issue 1, p18
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
We studied the background gastric mucosa in eight patients with intractable peptic ulcer in whom gastric cancer developed during more than 4 years' administration of histamine (H)2-receptor antagonists (H2-RAs), and in two patients with intractable gastric ulcer without gastric cancer in whom H2-RAs were administered for 4 years. As controls, we studied background mucosa in seven patients with combined gastroduoderal ulcers not treated with H2-RAs. The cancers were differentiated adenocarcinomas in all eight patients. The characteristic features of these patients and of the two patients with intractable gastric ulcer were: expansion of the generative cell zone, poor differentiation of the goblet cells, mild cellular atypia, and abnormal branching and anastomosis of glands, as well as wide areas of incomplete-type intestinal metaplasia. The sites of the differentiated adenocarcinomas were classified by mucin histochemistry as intestinal-type mucosa in all patients. A special type of incomplete intestinal metaplasia, of the intestinal type and which retained gastric-type properties, was present in some areas, and p53-positive cells were observed in some areas. In patients with intractable gastric ulcer in whom the background gastric mucosa had been exposed to more than 4 years of H2-RA treatment, it was considered possible that the preconditions for cancerous lesions were present.
ACCESSION #
4690106

 

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