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May 13, 1974

Histogenesis and Premalignant Lesions

JAMA. 1974;228(7):886-888. doi:10.1001/jama.1974.03230320050038

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FROM A histological point of view, the development of gastric carcinoma involves three fundamental problems: the cellular origins of cancer cells, the developmental sequences of cancer, and the premalignant conditions. Important information is available, although it is incomplete and in some aspects, controversial. I report the current thoughts on these problems.

Cellular Origins of Carcinoma.—  The gastric mucosa presents a complex composition, both normally and in pathological states. As far as carcinomas are concerned, evidence indicates that the mucus-producing cells and their variants are primarily involved.30 The generation of foveolar mucus cells occurs in the neck portion of the normal stomach. Frequently, the newly formed cells are poorly differentiated, ie, at the margin of a chronic ulcer. In chronic injury, the gastric mucosa often transforms itself to simulate the mucosa of the small intestine, a phenomenon known as intestinal metaplasia. In severe cases, there is a total absence of