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Gut 2003;52:807-812 doi:10.1136/gut.52.6.807
  • Stomach

Gastric intestinal metaplasia as detected by a monoclonal antibody is highly associated with gastric adenocarcinoma

  1. Z K Mirza1,
  2. K K Das1,
  3. J Slate1,
  4. R N Mapitigama2,
  5. P S Amenta1,
  6. L H Griffel1,
  7. L Ramsundar1,
  8. J Watari3,
  9. K Yokota3,
  10. H Tanabe3,
  11. T Sato3,
  12. Y Kohgo3,
  13. K M Das1
  1. 1Departments of Medicine and Pathology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
  2. 2Muhlenberg Regional Medical Center, Plainfield, NJ, USA
  3. 3Asahikawa Medical College, Asahikawa, Japan
  1. Correspondence to:
    Dr K M Das, UMDNJ-Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, New Brunswick, NJ 08903, USA;
    Daskm{at}umdnj.edu
  • Accepted 17 December 2002

Abstract

Background: Some forms of gastric intestinal metaplasia (GIM) may be precancerous but the cellular phenotype that predisposes to gastric carcinogenesis is not well characterised. Mucin staining, as a means of differentiating GIM, is difficult. A monoclonal antibody, mAb Das-1 (initially called 7E12H12), whose staining is phenotypically specific to colon epithelium, was used to investigate this issue.

Methods: Using mAb Das-1, by a sensitive immunoperoxidase assay, we examined histologically confirmed GIM specimens from two countries, the USA and Japan. A total of 150 patients comprised three groups: group A, GIM (fields away from the cancer area) from patients with gastric carcinoma (n=60); group B, GIM with chronic gastritis (without gastric carcinoma) (n=72); and group C, chronic gastritis without GIM (n=18).

Results: Fifty six of 60 (93%) patients with GIM (both goblet and non-goblet metaplastic cells) from group A reacted intensely with mAb Das-1. Cancer areas from the same 56 patients also reacted. In contrast, 25/72 (35%) samples of GIM from patients in group B reacted with mAb Das-1 (group A v B, p<0.0001). None of the samples from group C reacted with the mAb.

Conclusions: Reactivity of mAb Das-1 is clinically useful to simplify and differentiate the phenotypes of GIM. The colonic phenotype of GIM, as identified by mAb Das-1, is strongly associated with gastric carcinoma.

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