A number of studies have shown the association of gastric adenocarcinogenesis with intestinal metaplasia. Metaplasia means transformation of a mature form of cells into another type of mature cells in response to certain stimuli. In this case, gastric mucosal cells are converted to intestinal mucosal cells, especially goblet cells and Paneth cells. Indeed, it is believed that approximately one-third of all gastric adenocarcinoma is associated with intestinal metaplasia.24'34

However, based on the observation of H. pylori-associated gastritis, the number of H. pylori and the severity of inflammation are rather decreased at the stage of intestinal metaplasia. At present, the mechanism of the association of intestinal metaplasia and carcinogenesis is not well understood. This might be an adaptive change or a precancerous change.35

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