ENDOSCOPIC STUDIES ON THE INTESTINAL METAPLASIA OF THE GASTRIC MUCOSA

Abstract

Fifty-eight biopsied specimens from the part of intestinal metaplasia of the gastric mucosa were treated with alkaline phosphatase (ALP) and leucine aminopeptidase (LAP) staining methods. From the patlerns of the enzymological reaction, the intestinal metaplasia could be classified into following three types. Type 1: ALP activity (-), LAP activity (-) Type 2: ALP activity (-), LAP activity (+) Type 3: ALP activity (+), LAP activity (+) Then we studied the relation between endoscopic appearances and enzyme activity of the intestinal metaplasia. The fine surface structure of the metaplastic mucosa corresponding to biopsy were obserbed by the magnifying f ibergastroscopy (FGS-ML). These fine endoscopic patterns were classified into 5 types: FP, FIP, FSP, SP and MP, modified after Yoshii's classification. The ability of methylene blue absorption was also examined endoscopically. The fine surface appearance of the intestinal metaplasia corresponded to FSP, SP or MP. The relationship between degree of methylene blue absorption and fine endoscopic appearance was FSP<SP<MP, and degree of methylene blue absorption in the ALP positive intestinal metaplasia tissue was higher than the ALP negative intestinal metaplasia tissues. Tissue ALP-and LAP-activity in the intestinal metaplasia seemed to be in proportion to the degree of methylene blue absorption.