ROLE OF METAPLASIA IN GASTRIC CANCER CARCINOGENESIS

Abstract

Gastric cancer (GC) is an important cause of mortality worldwide and carries a poor prognosis. The five-year survival rate of late stage GC is only 5% hence it is imperative to diagnose GC at an early stage so that timely treatment can be provided to the patients. Intestinal metaplasia (IM) and spasmolytic polypeptide expressing metaplasia (SPEM) are the two common metaplasias observed in stomach, of which IM is accepted as a precursor of intestinal-type GC while SPEM is only recently recognized entity. In this thesis, I have found that in moderate to marked IM samples, MUC5AC expression, multifocal IM, copy number alterations and shortened telomere length and SPEM are the risk factors for progression to gastric dysplasia/adenocarcinoma. Furthermore, the presence of SPEM could be an additional marker for gastric atrophy. Lastly, genomic alterations in SPEM were studied which, to the best of our knowledge, has not been done before.