Recent evidence suggests that intestinal metaplasia (IM) cannot be regarded as a single entity. A simple classification of IM and its variants based on histological and mucin histochemical criteria was devised, and the incidence of IM subtypes in cancerous and benign gastrectomy specimens was recorded. A particular subtype was associated with 'intestinal' cancers but not with tumours considered to arise in normal gastric epithelium (P < 0.01) or with benign lesions (P < 0.01). This subtype appeared to lack absorptive cells at light microscopic level and secreted both neutral and acid mucins, including marked amounts of sulphomucin but no O-acetyl sialomucin.
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