What Does Mild Intestinal Metaplasia of the Gland Mean?

Mild intestinal metaplasia of the glandular epithelium refers to a change in the epithelium of the gastric mucosa. When the gastric mucosal epithelium transforms into small intestine or large intestine mucosal epithelial tissue containing goblet cells or epithelial Paneth cells, it is considered intestinal metaplasia. Under normal conditions, the undifferentiated cell tissue at the neck of the gastric glands constantly differentiates into gastric epithelial cells to replace the surface epithelial tissue that gradually ages and falls off. However, when the undifferentiated cell tissue at the neck of the glands enters a pathological state, it may differentiate into intestinal epithelial cells, leading to intestinal metaplasia.

Furthermore, research has also found that the gastric crypts are the main foci of intestinal metaplasia. These small foci gradually develop towards the surrounding gastric compartments, transforming into small foci and large patches of intestinal metaplasia.

Based on the function of the metaplastic epithelium in patients, intestinal metaplasia can be classified into two major types: complete and incomplete. Complete intestinal metaplasia exhibits pathological features similar to the absorptive cells of the small intestinal mucosa, including Paneth cells, absorptive cells, and goblet cells. It also contains various digestive enzymes such as leucine aminopeptidase, alkaline phosphatase, sucrase, and trehalase. In contrast, incomplete intestinal metaplasia lacks trehalase in the cytoplasm but contains mucus secretory granules and sucrase. The activity of alkaline phosphatase and aminopeptidase is low in this type of metaplasia.

It is noteworthy that incomplete intestinal metaplasia is also known as colonic-type metaplasia, which is closely associated with the occurrence of gastric cancer. The age of onset of intestinal metaplasia is often later than that of complete intestinal metaplasia, but the two types can coexist. Additionally, incomplete intestinal metaplasia may arise as a gradual progression of complete intestinal metaplasia.

Although mild intestinal metaplasia indicates a relatively mild degree of gastric mucosal intestinal metaplasia, it should not be overlooked. Clinical observations suggest that patients with chronic gastritis often have intestinal metaplasia, especially those with chronic atrophic gastritis. These patients should actively seek treatment.