Pathogenesis and potential reversibility of intestinal metaplasia − a milestone in gastric carcinogenesis

Drnovšek, Jan (author), Homan, Matjaž (author), Zidar, Nina (author), Šmid, Lojze (author)

Background. Non-cardia gastric cancer remains a major cause of cancer-related mortality worldwide, despite declining incidence rates in many industrialized countries. The development of intestinal-type gastric cancer occurs through a multistep process in which normal mucosa is sequentially transformed into hyperproliferative epithelium, followed by metaplastic processes leading to carcinogenesis. Chronic infection with Helicobacter pylori is the primary etiological agent that causes chronic inflammation of the gastric mucosa, induces atrophic gastritis, and can lead to intestinal metaplasia and dysplasia. Both intestinal metaplasia and dysplasia are precancerous lesions, in which gastric cancer is more likely to occur. Atrophic gastritis often improves after eradication of Helicobacter pylori; however, the occurrence of intestinal metaplasia has been traditionally regarded as “the point of no return” in the carcinogenesis sequence. Helicobacter pylori eradication heals non-atrophic chronic gastritis, may lead to regression of atrophic gastritis, and reduces the risk of gastric cancer in patients with these conditions. In this article, we discuss the pathogenesis, epigenomics, and reversibility of intestinal metaplasia and briefly touch upon potential treatment strategy. Conclusions. Gastric intestinal metaplasia no longer appears to be an irreversible precancerous lesion. However, there are still many controversies regarding the improvement of intestinal metaplasia after Helicobacter pylori eradication

• Language: English
• Keywords: helicobacter pylori, intestinal metaplasia, gastric cancer
• Work type: Article
• Typology: 1.02 - Review Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: Str. 186-195
• Numbering: Vol. 58, iss. 2
• PID: 20.500.12556/RUL-183343
• UDC: 61
• ISSN on article: 1318-2099
• DOI: 10.2478/raon-2024-0028
• COBISS.SI-ID: 200321027
• Publication date in RUL: 11.06.2026

Record is a part of a journal

• Title: Radiology and oncology
• Shortened title: Radiol. oncol.
• Publisher: Slovenian Medical Society - Section of Radiology, Croatian Medical Association - Croatian Society of Radiology
• ISSN: 1318-2099
• COBISS.SI-ID: 32649472

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Title: Patogeneza in potencialna reverzibilnost intestinalne metaplazije-mejnik v karconogenzi želodca