한국인 위질환에 있어서의 위점막 장형화생에 관한 연구

Abstract

the stomach. It has been recognized since 1883 by Kiipffer. Its orgin and significance have been still not clearly understood. Two hypothesis have been proposed for the origin of intestinal type epithelium in the stomach. One suggests that the intestinal epithelium results from heterotopic tissue present at birth due to a residual embryonal cell or tissues. These cells or tissues differentiate and/or proliferate with disease (heterot• opia)6,52 ,58,78) The second theory, the more widely held, that the mucosal tissue is regenerated and/or differentiated to the intestinal epithelium as a result of chronic irritations which are not as a congenital one but acquired (metaplasia). The chraceteristics of intestinal elements in the stomach lining are 1) columnar cells, with a striated border on their free surface. 2) goblet cells , and 3) Paneth cells and/or argentaffin cells. The aberrent intestinal epithelium has been observed r in chronic inflammatory conditl6ns, peptic ulcer , carcinoma of stomach, polyp and other exert a destructive effect upon the gastric mucosa by many authors" 52,78. 88 2G. '0, G) It has been considered to be a premalignant conditions" 31. 52 ,78). This view is supported by the presence of metaplastic component such as striated cell borders'!) or enzyme characteristic of intestinal epithelium"). The other hand, its view is denied by some authors!5, GO) Recent electron microscopic studies have shown the abberrent epithelium to be identical in fine structure and histological arrangement with normal jejunal epithelium63 • 67) . In this aspect, like normal jejunal epithlium, the intestinalized gastric epithelium is able to transport dietary and micellar lipid from the bowel lumen into the adjacent lamina propria, in this manner more lipid can be detected in metaplastic epitheliumGG). Some authors induced the intestinal epithelium in the gastric mucosa experimentally by dietary carcinogen7), histamin8), toxic substance'G) or sclerosing compoundG). The frequency of intestinalization is various record in 11 to 100 per cent of the stomach specimen e~;amined. The author tried to recogniz of intestinalization of Korean adults by resected specimens on the view of relationships between the various gastric disease and metaplasia on clinical and pathological aspects. Following were the results: 1) In 50 cases of control stomachs obtained by autopsy in the present study, the following data were obtained. The intestinal metaplasia was recognized in 3 cases (6% ), of which 2 were combined with gastritis The fat droplet could not found in any cases. Mucosal atrophy was found in 3 cases and lymph follicle was 2 cases out of 6 cases with gastritis of autopsy specimens. 2) Intestinalization was found in the gastric mucosa in 193 cases (49.7%) out of 3S9 resected stomach group. 3) The greatest frequency of intestinal metaplasia was in the carcinoma of the stomach 56% followed by stomach ulcer 53%, polyp 50%. gastritis 38%.