Pericryptal fibroblast sheath in intestinal metaplasia, dysplasia and carcinoma of the stomach

Objective: To investigate the existence of pericryptal fibroblasts sheath (PCFS) in normal gastric mucosa, intestinal metaplasia (IM), indefinite for dysplasia (I-Dys), low grade dysplasia (L-Dys), high grade dysplasia (H-Dys) and gastric cancer (GC), and its association with gastric carcinogenesis. Methods: In this study, we examined the existence of PCFS in normal gastric mucosa (N=10), IM (N=26), I-Dys (N=16), L-Dys (N=13), H-Dys (N=21) and GC (N=145) using immunohistochemical staining for two smooth muscle markers, alpha smooth muscle actin(α-SMA) and high molecular weight caldesmon (h-CD). The significance of PCFS was discussed, especially in association with gastric carcinogenesis. Results: The PCFS was recognized in 65.4%(17/26) of IM, 62.5%(10/16) of I-Dys and 23.1% (3/13) of L-Dys respectively. No PCFS was detected in H-Dys and GC. The PCFS was gradually reduced in IM, Dys and GC in sequence (P<0.0001). Conclusion: The PCFS is associated with the differentiation of epithelium and involved in gastric carcinogenesis via epithelial-mesenchymal interaction.