PTH-192 Gastric adenocarcinoma of diffuse type develops on a healthy-looking mucosal background, unlike intestinal type gastric adenocarcinoma
Bibliographic record
Abstract
Introduction Intestinal type gastric adenocarcinoma develops in an inflammatory and atrophic background with profound loss of secretory cells. Little is known about background gastric mucosa in diffuse type adenocarcinoma. Method Total gastrectomy specimens from non-tumoural body mucosa were selected from 22 patients with diffuse type gastric adenocarcinoma. A frequency-matched group of 22 specimens from patients with intestinal type gastric adenocarcinoma were included as comparison. Well-oriented sections were immunostained for H/K ATPase (parietal cells) and Pepsinogen I (chief cells). Absolute mucosal cell density (per mm2) was measured and expressed as mean (±SD). Inflammatory changes were scored by a semi-quantitative method in both groups. Results The background densities of parietal cells (PC) and chief cells (CC) were significantly higher in diffuse type than intestinal type cancers, being 665 (±216) vs. 412 (±170) cells/mm2, p < 0.001; and 847 (±259) vs. 443 (±206) cells/mm2, p < 0.001, respectively. Glandular layer was significantly thicker in diffuse type [811 (±161) µm] vs. intestinal type [610 (±140) µm, P < 0.001]. In contrast, length proportion of intestinal metaplasia was higher in intestinal type than diffuse type [23% (±30) vs 4% (±13), p < 0.005]. Mucosal inflammation was less in diffuse versus intestinal type adenocarcinoma expressed by infiltration score of mononuclear cells (p = 0.011) and reactive changes (p = 0.005), but not in polymorphonuclear cell. Secretory cell densities and inflammation were inversely correlated in both cancer types. Conclusion The background mucosa in diffuse type gastric adenocarcinoma is much healthier than that of intestinal type adenocarcinoma, with more functional secretory cells, thicker gastric glands, less atrophy, less inflammation and less intestinal metaplasia. This suggests the existence of separate aetiological pathways leading to these distinct types of gastric adenocarcinoma. Disclosure of interest None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".