<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3>
<p>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 <italic>Helicobacter pylori</italic> 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 <italic>Helicobacter pylori</italic>; however, the occurrence of intestinal metaplasia has been traditionally regarded as “the point of no return” in the carcinogenesis sequence. <italic>Helicobacter pylori</italic> 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.</p>
</sec>
<sec><h3>Conclusions</h3>
<p>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 <italic>Helicobacter pylori</italic> eradication.</p>
</sec>
</abstract>

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.

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

Institute of Pathology, Faculty of Medicine

Department of Gastroenterology, Hepatology and Nutrition

Radiology and Oncology

This work is licensed under the Creative Commons Attribution 4.0 International License.

Background
Non-cardia gastric cancer remains a major cause of cancer-related mortality worldwide, despite declining incidence rates in many industrialized...

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

Article Category: Review

Published Online: Apr 21, 2024

Page range: -

Received: Nov 03, 2023

Accepted: Mar 19, 2024

DOI: https://doi.org/10.2478/raon-2024-0028

Keywords
intestinal metaplasia, gastric cancer

© 2024 Jan Drnovsek et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

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

Article Category: Review

Published Online: Apr 21, 2024

Page range: -

Received: Nov 03, 2023

Accepted: Mar 19, 2024

DOI: https://doi.org/10.2478/raon-2024-0028

Keywordsintestinal metaplasia, gastric cancer

© 2024 Jan Drnovsek et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Keywords
intestinal metaplasia, gastric cancer