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THEMES
1Nashville Department of Veterans Affairs Medical Center and 2Department of Surgery and Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Nashville, Tennessee; and 3Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Submitted 2 May 2006 ; accepted in final form 15 May 2006
Gastric cancer in humans arises in the setting of oxyntic atrophy (parietal cell loss) and attendant hyperplastic and metaplastic lineage changes within the gastric mucosa. Helicobacter infection in mice and humans leads to spasmolytic polypeptide-expressing metaplasia (SPEM). In a number of mouse models, SPEM arises after oxyntic atrophy. In mice treated with the parietal cell toxic protonophore DMP-777, SPEM appears to arise from the transdifferentiation of chief cells. These results support the concept that intrinsic mucosal influences regulate and modulate the appearance of gastric metaplasia even in the absence of significant inflammation, whereas chronic inflammation is required for the further neoplastic transition.
gastric adenocarcinoma; spasmolytic polypeptide-expressing metaplasia; trefoil factor 2; intestinal metaplasia
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