Immunological Dysfunction with Atrophic Gastritis and Gastric Malignancy

  • Jeremiah J. Twomey
Part of the Sloan-Kettering Institute Cancer Series book series (SKICS)


Atrophic gastritis is an indolent disease of the stomach of unknown etiology. Histologiçally normal glandular gastric mucosa is replaced by flat colonic-type endothelium and the submucosa is heavily infiltrated with immune reactive cells (Fenwick, 1870; Coghill, 1960; Wood et al, 1964). The stomach loses its ability to secrete hydrochloric acid, pepsin, and intrinsic factor (Levine and Ladd, 1921; Castle, 1929) and serum gastrin levels are elevated when antral mucosa is preserved (McGuigan and Trudeau, 1970; Strickland and Mackay, 1973; Hughes et al., 1972). The lack of intrinsic factor secretion due to atrophic gastritis causing vitamin B12 malabsorption is the basic lesion of pernicious anemia (Castle, 1929). Patients with pernicious anemia require lifelong parenteral vitamin B12 replacement. Much still remains to be learned about the etiology and pathophysiology of atrophic gastritis. It is not known whether atrophic gastritis results from one or more pathogenetic mechanisms. It is not understood why (1) various autoimmune phenomena, (2) other immunological disorders, and (3) outwardly unrelated diseases involving other organs frequently coexist with atrophic gastritis. Patients with atrophic gastritis have an increased risk of developing cancer of the stomach. It is not known whether this association is an unexplained coincidence or whether atrophic gastritis is a precancerous condition. The primary objectives of this chapter are to review current information about immunological perturbations with atrophic gastritis and gastric carcinoma and to discuss the potential significance of these perturbations.


Multiple Myeloma Gastric Mucosa Parietal Cell Intrinsic Factor Atrophic Gastritis 
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Copyright information

© Springer Science+Business Media New York 1978

Authors and Affiliations

  • Jeremiah J. Twomey
    • 1
  1. 1.Baylor College of MedicineVeterans Administration HospitalHoustonUSA

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