Relation of adenomatous hyperplasia of the gastric mucosa to carcinogenesis.
Experimental studies of stomach carcinogenesis were carried out in two series of Wistar rats (66 and 174 animals). In both series submucosal foci of adenomatous hyperplasia were observed either without atypia, or with atypia at different, gradually increasing degrees. The number of these focal lesions in the submucosa (87 in the first series) was smaller than that of focal dysplastic changes with varying grades of atypia within the mucosa. On the basis of different degrees of atypia observed in these adenomatous hyperplasias, we have to assume that a phase shifting occurs in those areas that show lower grades or absence of atypia. In the framework of carcinogenesis this kind of adenomatous hyperplasia is interpreted as an incomplete or incompletely persisting carcinogenesis. In analogy to our experimental findings we found identical lesions in three human cases where different grades of atypia were observed distant from the primary stomach cancer. These results are discussed with reference to the animal experiments and to the literature.