A Study on Alkaline and Acid Phosphatase of Normal and Atrophic Gastric Mucosa with Special Reference to Intestinal Metaplasia

Abstract

The activities of alkaline and acid phosphatase were determined in the mucosa of seventy resected stomachs with various diseases. In this report a special reference is made concerning intestinal metaplasia.
1. In the normal gastric mucosa, distribution of alkaline phosphatase was limited to capillary walls, endothelium of blood vessels and reticular fibers in the periphery of lymph follicles. In atrophic parts of the mucosa, positive reactions of metaplastic epithelium and granular leucocytes were also noted.
2. The distribution of acid phosphatase was different from alkaline one. Even in the normal gastric mucosa, acid phosphatase-activity was observed in varying degrees in surface and glandular epithelia and various kinds of interstitial migrating cells, but it was far weaker in capillary walls, blood vessel endothelium and reticular fibers in the periphery of lymph follicles than alkaline phosphatase-activity. On the other hand, metaplastic epithelium in the mucosa with atrophic changes showed an intense activity of acid phosphatase, while granular leucocytes were practically devoid of the activity.
3. Some of the gastric epithelial cells with intestinal metaplasia resembled the common epithelial cells of the small intestine in morphological appearance and phosphatase-activity (typical metaplastic cells), while others differed in the forms and phosphatase-activity from the normal intestinal epithelium (atypical metaplastic cells).
4. In the normal small intestine, all the common epithelium of the villi except their roots was occupied by cells showing intense alkaline and acid phosphatase-activity. On the contrary, however, in the intestinal metaplastic epithelium of the gastric mucosa, these intensely activated cells either decreased in number or disappeared, and frequently the superficial part of the metaplastic mucosa was lined by the aforementioned atypical cells and the typical ones similar to the epithelium of the roots of the intestinal villi or the upper halves of the crypts, which were all weaker in phosphatase-activity.
5. Metaplastic epithelium which occurred in the regenerative areas, such as the area surrounding the erosions and ulcers, the surface of scar tissue and so on, showed weak alkaline and acid phosphatase-activity. However, as the atrophic changes progressed, phosphataseactivity gradually increased.
6. Alkaline and acid phosphatase-activity of metaplastic epithelium were generally intense in the stomachs with anacidity, high degree of intestinal metaplasia and cancer, but, on the contrary, weak in those with hyperacidity, slight degree of intestinal metaplasia and chronic gastritis. In addition, the phosphatase-activity of metaplastic epithelium was more intense in the fundus than in the pyloric regions.