Subtypes of intestinal metaplasia and gastric carcinoma. A clinicoendoscopic follow-up of 112 cases.

Nine tumor-associated antigens (MG7-, MGdl-, MC3-corresponding antigens, CEA, P21ras, Sialoglycoprotein, CA 19-9-like, Sialo-Tn and Le8-like antigens) were investigated on biopsy specimens of different types of intestinal metaplasia (types I, II and III) taken from 112 patients with benign gastric conditions. The incidence of positive staining for 9 antigens except for P21ras in type III intestinal metaplasia was significantly higher than that in types I and II (P less than 0.05-0.01). These 112 patients were clinicoendoscopically followed up for 15-70 months. Five of them were found to develop gastric carcinomas within 25-60 months, giving a cancer detection rate of 4.5%. They were detected from type III (16.1%) patients, but none was found in patients of types I and II, and the differences were significant (P less than 0.05-0.01). Our results indicate that type III intestinal metaplasia has a higher potentiality in developing malignancy and that MG7, MGd1, MC3, CEA, CA19-9-like and Sialo-Tn antigens are valuable tumor markers in defining the high-risk group of gastric carcinoma.