Intestinal metaplasia is the transformation (

metaplasia Metaplasia ( gr, "change in form") is the transformation of one differentiated cell type to another differentiated cell type. The change from one type of cell to another may be part of a normal maturation process, or caused by some sort of abn ...

) of epithelium (usually of the

stomach The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach i ...

or the

esophagus The esophagus (American English) or oesophagus (British English; both ), non-technically known also as the food pipe or gullet, is an organ in vertebrates through which food passes, aided by peristaltic contractions, from the pharynx to the ...

) into a type of epithelium resembling that found in the

intestine The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans a ...

. In the esophagus, this is called

Barrett's esophagus Barrett's esophagus is a condition in which there is an abnormal ( metaplastic) change in the mucosal cells lining the lower portion of the esophagus, from stratified squamous epithelium to simple columnar epithelium with interspersed goblet cel ...

. Chronic inflammation caused by '' H. pylori'' infection in the stomach and GERD in the esophagus are seen as the primary instigators of metaplasia and subsequent

adenocarcinoma Adenocarcinoma (; plural adenocarcinomas or adenocarcinomata ) (AC) is a type of cancerous tumor that can occur in several parts of the body. It is defined as neoplasia of epithelial tissue that has glandular origin, glandular characteristics, o ...

formation. Initially, the transformed epithelium resembles the

small intestine The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through t ...

lining; in the later stages it resembles the lining of the colon. It is characterized by the appearance of

goblet cell Goblet cells are simple columnar epithelial cells that secrete gel-forming mucins, like mucin 5AC. The goblet cells mainly use the merocrine method of secretion, secreting vesicles into a duct, but may use apocrine methods, budding off their se ...

s and expression of intestinal cell markers such as the

transcription factor In molecular biology, a transcription factor (TF) (or sequence-specific DNA-binding factor) is a protein that controls the rate of transcription of genetic information from DNA to messenger RNA, by binding to a specific DNA sequence. The fu ...

, CDX2.

Risk factors

Although it was originally reported that people of East Asian ethnicity with gastric intestinal metaplasia are at increased risk of

stomach cancer Stomach cancer, also known as gastric cancer, is a cancer that develops from the Gastric mucosa, lining of the stomach. Most cases of stomach cancers are gastric carcinomas, which can be divided into a number of subtypes, including gastric adenoca ...

, it is now clear that gastric intestinal metaplasia is also a risk factor in low-incidence regions like Europe. Risk factors for progression of gastric intestinal metaplasia to full blown cancer are smoking and family history.

References

{{Reflist

External links

AGA Clinical Practice Guidelines on Management of Gastric Intestinal Metaplasia

Intestinal metaplasia (definition)
– mondofacto.com. Gastrointestinal tract disorders Types of cancer