Incidence of Intestinal Metaplasia and Dysplasia in Patients of Infectious and Non-infectious Chronic Gastritis- A Hospital Based Study in Varanasi

  • Praveen A Shinde Associate Professor, Department of Pathology, Heritage Institute of Medical Sciences, Varanasi.
Keywords: Intestinal metaplasia, Chronic gastritis, Dysplasia


Background: Chronic gastritis is defined as presence of chronic mucosal inflammatory changes leading eventually to mucosal atrophy and intestinal metaplasia. Aim: This study was carried out to know the prevalence of Intestinal Metaplasia (IM) in gastric biopsies, and to find out the association between H. pylori, Intestinal metaplasia and dysplasia and to assess the age and sex distribution of the IM in gastric biopsies.

Methods: This prospective study was performed in age group of 25-65 years, attending outpatient Medicine department of Heritage Institute of Medical Sciences, Varanasi, a tertiary care Centre.

A total number of 103 antral gastric biopsies were collected in Pathology department of Heritage Institute of Medical Sciences, Varanasi and examined histologically to detect intestinal metaplasia. These biopsies were stained by Giemsa to detect H. pylori organisms.

Results: H. pylori was found in 47 (46%) patients (25-65 years; mean age 45.8). Intestinal metaplasia in general was found in 15 (15%) patients. Intestinal metaplasia that is associated with H. pylori seen in 10 (9.8%) patients, while intestinal metaplasia without H. pylori seen in 5 (4.9%) patients. Among intestinal metaplasia 3 cases show dysplasia (3/103 = 2.9%)

 Conclusions: This study has documented mainly that the prevalence of intestinal metaplasia is significant among patients with chronic gastritis and mainly in those patients who are positive for H. pylori with an active chronic gastritis. Intestinal metaplasia mostly affects patients above the age of 40 years with no significant gender difference.


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1. Pelayo Correa, M. Blanca Piazuelo, Keith T. Wilson. Pathology of gastric intestinal metaplasia: clinical implications. Am J Gastroenterol. 2010;105(3):493-8.
2. Marshal BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulcer. Lancet. 1984;1:1311-5.
3. S-J. Tang, R. Wu F Bhaijee. Intestinal metaplasia of the gastric IM is categorized histopathologically into incomplete and complete types. Patients with incomplete IM should undergo endoscopic gastric mapping to define the extent of IM and rule out dysplasia or adenocarcinoma. Stomach. 2013;1(1):187-9.
4. H. Bashar, Mazin Al-Mukhtar. The demonstration of Helicobacter pylori in the gastroduodenal endoscopic biopsies by using different stains. Tikrit Med J. 2004;10(2)1-7.
5. Vinyy Kumar, Abul K. Abbas, Nelson Fausto. Intestinal metaplasia. In: Vinyy Kumar, Abul K. Abbas, Nelson Fausto, eds. Robbins and Cotran Pathologic Basis of Disease. 7th ed. Philadelphia: Saunders; 2004: 813-823.
6. Kang KP, Lee HS, Kim N, Kang HM, Park YS, Lee DH, et al. Role of intestinal metaplasia subtyping in the risk of gastric cancer in Korea. J Gastroenterol Hepatol. 2009;24(1):140-8.
7. Juan Rosai. Intestinal metaplasia. In: Juan Rosai, eds. Rosi and Ackerman’s Surgical Pathology. 9th ed. US: Mosby; 2011: 663.
8. International Agency for Research on Cancer. Schistosomes, liver flukes and Helicobacter pylori. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Lyon, France: IARC, World Health Organization; 1994; 61.
9. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process. First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992;52:6735-40.
10. Correa P, Haenszel W, Cuello C, Tannenbaum S, Archer M. A model for gastric cancer epidemiology. Lancet. 1975;2:58-60.
11. Filipe MI, Munoz N, Matko I, Kato I, Pompe-Kirn V, Jutersek A, et al. Intestinal metaplasia types and the risk of gastric cancer: a cohort study in Slovenia. Int J Cancer. 1994;57:324-9.
12. Espey DK, Wu XC, Swan J, Wiggins C, Jim MA, Ward E, et al. Annual report to the nation on the status of cancer, 1975-2004, featuring cancer in American Indians and Alaska Natives. Cancer. 2007;110:2119-52.
13. Wu X, Chen VW, Andrews PA, Ruiz B, Correa P. Incidence of esophageal and gastric cancers among Hispanics, non-Hispanic whites and non-Hispanic blacks in the United States: subsite and histology differences. Cancer Causes Control. 2007;18:585-93.
14. Fennerty MB, Emerson JC, Sampliner RE, McGee DL, Hixson LJ, Garewal HS. Gastric intestinal metaplasia in ethnic groups in the South-Western United States. Cancer Epidemiol Biomarkers Prev. 1992;1:293-6.
15. Morson BC, Sobin LH, Grundmann E, Johansen A, Nagayo T, Serck-Hanssen A. Precancerous conditions and epithelial dysplasia in the stomach. J Clin Pathol. 1980;33:711-21.
16. Carillho C, Modcoicar P, Cunha L, Ismail M, Guissive A, Lorinzoni C, et al. Prevalence of H. pylori, chronic gastritis and intestinal metaplasia in Mozambican dyspeptic patients. Int J Pathol. 2008;4(20):297.
17. Hackelsberger A, Guther T, Schultze V, Labenz J, Roessner A, Malfertheiner P. Prevalence and pattern of H. pylori gastritis in gastric cardia. Am J Gastroenterol. 1997;92(12):2220-4.
18. Kim HJ, Choi BY, Byun TJ, Eun CS, Song Kim YS, Han DS. The prevalence of Atrophic gastritis and intestinal metaplasia according to gender, age and H. pylori infection in a rural population. J Prev Med Public Health. 2008;41(6):373-9.
19. Zhang C, Yamada N, Wu YL, Wen M, Matsuhisa T, Matsukura N. H. pylori infection glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer. World J Gastroenterol. 2005;11(6):791-6.
20. Al-Kanawi B, Mordan N, Jamal A, Mirdad S, Abol Fotouh M, Ahemd ME, et al. H. pylori and intestinal metaplasia with its subtyping in gastric antrum in a Saudi population. Scand J Gastroenterol. 1999;34(6):562-5.
21. Khan AR. An age- and gender-specific analysis of H. pylori infection. Ann Saudi Med. 1998;18:6-8.
How to Cite
Shinde PA. Incidence of Intestinal Metaplasia and Dysplasia in Patients of Infectious and Non-infectious Chronic Gastritis- A Hospital Based Study in Varanasi. Int Arch BioMed Clin Res [Internet]. 2016Dec.28 [cited 2019Oct.17];2(4):64-6. Available from: