A Study of Mitotic Rate in Renewal Zones of Nondiseased Portions of Gastric Mucosa in Cases of Peptic Ulcer and Gastric Cancer, With Observations on Differentiation and So-Called “Intestinalization” of Gastric Mucosa2
The mitotic rate in the zone of renewal was determined in the body and pyloric mucosa and in areas of so-called intestinalization outside the actual disease process in human stomachs removed, partially or totally, for duodenal ulcer (32 cases), gastric ulcer (35 cases), and gastric cancer (17 cases). In the material from stomachs of gastric-ulcer and cancer patients the mitotic rate in the body and pyloric mucosa was of the same magnitude and was highly significant (PP<0.01) than that of the body. Also, the mitotic rate in intestinal-type glands in material from gastric-ulcer and cancer patients was slightly greater than in materials from duodenal-ulcer patients. Intestinal-type glands in the pyloric region were observed in 78 percent of the cancer, 60 percent of the gastric-ulcer, and 25 percent of the duodenal-ulcer groups. They were more numerous in the pyloric part than in the body mucosa, and considerably more profuse in the first 2 groups. Intestinalization of the gastric mucosa has been considered primarily a sign of general differentiation disturbance. Gastric-ulcer and cancer stomachs showed, in addition to intestinalization in the superficial epithelium, incomplete cell differentiation and numerous pyknotic and karyorrhectic cells. These changes were rare in duodenal-ulcer cases. The highest incidence of cell renewal, of intestinal-type ephithelium and other differentiation disturbances, and of stomach cancer occurred in the same age group and may be related phenomena.