LEADING ARTICLE

Is intestinal metaplasia of the stomach reversible?

M M Walker

Correspondence to:
Correspondence to:
M M Walker, Department of Histopathology, Faculty of Medicine, Imperial College of Science, Technology and Medicine, St Mary’s Campus, Norfolk Place, London W2 1PG, UK; mm.walker{at}ic.ac.uk

Intestinal metaplasia (IM) of the stomach is a risk factor in developing intestinal-type gastric cancer and hence the question of reversibility is vital. There is emerging epidemiological evidence that with long term follow up, IM may be reversible although a combination of antioxidant agents and eradication of H pylori may be necessary to achieve this. The pathogenesis of IM is currently being elucidated and it is likely that a combination of bacterial, host, and environmental factors will be shown to lead to IM. In assessing gastric cancer risk, histochemical typing of IM will most probably be replaced by molecular markers.

Keywords: Helicobacter pylori; intestinal metaplasia; biopsy; endoscopy

Abbreviations: IM, intestinal metaplasia; COX-2, cyclooxygenase 2; MSI, microsatellite instability

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