Ciliated metaplasia (CM) in the stomach is mainly found in gastric mucosa that harbours gastric cancer. The true nature of this lesion and the regulatory factors responsible for the formation of CM are unknown. Broncho-pulmonary differentiation is controlled by the homeodomain transcription factor TTF-1 and ciliogenesis by the forkhead transcription factor HFH-4, respectively. Using immunohistochemistry, the present study shows that gastric CM is associated with the expression of TTF-1 and HFH-4. Furthermore, TTF-1 expression was found in non-ciliated cells in 50% of cases with atrophic gastritis, whereas TTF-1 and HFH-4 were not expressed in normal gastric mucosa or in non-atrophic gastritis. These data suggest that CM in the gastric mucosa can be regarded as gastric broncho-pulmonary transdetermination. Evidence for this particular transdetermination is frequently found in atrophic gastritis even without fully developed ciliated cells.
Copyright 2005 Pathological Society of Great Britain and Ireland