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September 11, 1943


JAMA. 1943;123(2):95-96. doi:10.1001/jama.1943.02840370027010

Konjetzny in 1913, working with freshly fixed, resected material, suggested that carcinoma of the stomach develops on an inflammatory basis. He formulated his concept of "gastritis hyperplastica atrophicans" and concluded that the greater portion of gastric carcinomas (about 85 per cent) arose on the basis of chronic gastritis and that the latter constitutes a precancerous condition. Investigations of Orator, including a study of 700 cases of ulcer and 150 of cancer, seemed to establish a close association between the presence of chronic gastritis and its allied intestinal metaplasia and that of gastric carcinoma. He concluded that about 80 per cent of gastric carcinomas arose on a basis of precancerous gastritis and that the remainder arose through cancerous transformation of gastric ulcers, so-called ulcerocancers. This opinion was supported by some workers in this field and was opposed by others. Some suggested that the gastritis was a result, rather than a cause,