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Gastric ciliated metaplasia. A study of 3406 gastrectomy specimens from dwellers of the Atlantic and the Pacific basins
  1. C A Rubio1,
  2. G Nesi2,
  3. G C Zampi2,
  4. P A de Ruiz3,
  5. J Jessurun3,
  6. J Jónasson4,
  7. R Hojman5,
  8. Z Kogan5,
  9. D Antonioli6,
  10. M L Miller7,
  11. T Hirota8,
  12. T Itabashi8,
  13. K Mandai9,
  14. T Kitagawa10,
  15. H Sugano10,
  16. Y Kato10,
  17. A King11,
  18. R Pisano12,
  19. D Owen13
  1. 1Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden
  2. 2Department of Pathology, Universitá Degli Studi di Firenze, Florence, Italy
  3. 3Department of Pathology, Universidad Atónoma de Méjico, Mexico City, Mexico
  4. 4Department of Pathology, University of Iceland, 121 Reykjavik, Iceland
  5. 5Department of Pathology, Hospital Municipal de Gastroenterología, Buenos Aires, Argentina
  6. 6Department of Pathology, Harvard Medical School, Beth Israel Hospital, Boston, USA
  7. 7Department of Environmental Health, University of Cincinnatti, Cincinnatti, USA
  8. 8Department of Pathology, National Cancer Center Research Institute, Tokyo 192, Japan
  9. 9Department of Pathology, National Shikoku Cancer Center Hospital, Matsuyama, Japan
  10. 10Department of Pathology, Cancer Institute, Tokyo, Japan
  11. 11Department of Pathology, Middlemore Hospital, Otahuhu, New Zealand
  12. 12Department of Pathology, Hospital Jaraquemada, Santiago, Chile
  13. 13Department of Pathology, University of British Columbia, Vancouver, Canada
  1. Correspondence to:
 Dr C A Rubio
 Gastrointestinal and Liver Pathology Research Laboratory, Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden;


Background: Ciliated cells in gastrectomies from patients dwelling in the Pacific and Atlantic basins have been reported previously.

Aim: To compare all the results in an attempt to explain the findings.

Methods: Sections from 3406 gastrectomies were reviewed: 1966 and 1440 from the Atlantic and Pacific basins, respectively. Ciliated cells and intestinal metaplasia (IM) were recorded; IM was classified into focal or extensive IM. The total number of sections/gastrectomy was noted.

Results: In the Atlantic basin, 5% of specimens had ciliated metaplasia (CM); it was more frequent in intestinal carcinoma (IC; 9%) than diffuse carcinoma (DC; 3%) or miscellaneous gastric diseases (MGD; 3%). In the Pacific basin, the frequency of specimens with CM was 29%: it was more frequent in IC (43%) than in DC (16%) or MGD (10%). The difference between the frequency of CM in specimens with IC or with DC/MGD in the Atlantic and the Pacific basins was significant (p ⩽ 0.05). The presence of CM was influenced by age and the extent of IM in both basins, but not by sex or the number of sections investigated.

Conclusions: CM—apparently an independent microscopic marker—was significantly higher in the Pacific than in the Atlantic basin. Environmental carcinogens involved in the evolution of IM and IC seem to be implicated in gastric ciliogenesis. Carcinogens that differ in nature and/or in strength in both basins might activate the latent natural genes encoding ciliated processes in gastric cells in patients subsequently developing gastric carcinoma, more notably of intestinal type.

  • DC, diffuse carcinoma
  • EIM, extensive intestinal metaplasia
  • IC, intestinal carcinoma
  • IM, intestinal metaplasia
  • MGD, miscellaneous gastric diseases
  • gastrectomy
  • ciliated metaplasia
  • carcinoma

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