J.Jpn. Surg. Soc.. 80(6): 500-511, 1979

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Original article

HISTOENZYMOLOGIC STUDY ON INTESTINAL METAPLASIA OF THE GASTRIC MUCOSA OF RESECTED GASTRIC CANCER TISSUE
Part 2. Histologic Findings

Utilizing the presence of disaccharidase which is considered to appear with intestinal metaplasia of the gastric mucosa, the correlation between morphologic intestinal metaplasia and color level determined by "Tes-Tape" method was studied. Close relation has been assumed between gastric cancer and intestinal metaplasia. The study was made on the site, gross findings, and histologic type by age and sex of intestinal metaplasia in early and advanced gastric cancer cases. H-E stain, Alcian-blue PAS stain, and alkaline phosphatase stain were made of enzymologic intestinal metaplasia by "Tes-Tape" method. A comparison was made between cancer foci and morphologic intestinal metaplasia in the periphery of these cancer foci and furthermore, observations were made on the changes of intestinal metaplasia located at the margin of the cancer foci. A report will be presented on some new findings obtained in this study.
1) Among lactase, trehalase, sucrase, and maltase, it has been found that lactase has hardly any correlation with morphologic intestinal metaplasia, while trehalase, sucrase, and maltase have a correlation with morphologic intestinal metaplasia in the order given. In observing the distribution of morphologic intestinal metaplasia, it is considered that maltase is the best procedure.
2) Although intestinal metaplasia has been classified into the complete and incomplete type, the complete type can be classified, but the incomplete type cannot under a definite criterion.
3) Early gastric cancer of the protruded type, being only of the differentiated type, showed a tendency of increasing with age. It tended to be located at A (lower) and the activity of sucrase and maltase in the periphery of the foci showed a tendency to increase in comparison with that of early gastric cancer of the poorly differentiated type.
4) The activity of sucrase and maltase tended to increase in early gastric cancer of the differentiated type when not accompanied by Paneth cells in the margin of the foci in comparison with that of early gastric cancer of the poorly differentiated type. A similar tendency was observed in advanced gastric cancer.
5) The rate in which the margin of the early gastric cancer of the differentiated type was in contact with the intestinal metaplasia both enzymologically and morphologically was higher than that in early gastric cancer of the poorly differentiated type. Furthermore, the rate in which the early gastric cancer of the differentiated type was in contact morphologically with incomplete intestinal metaplasia was higher than that of early gastric cancer of the poorly differentiated type and on the other hand there tended to be a high rate for it to be in contact enzymologically with complete intestinal metaplasia.

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