The Transitional Body-Antrum Zone in Resected Human Stomachs

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Abstract
The size of transitional body-antrum zone, where both parietal cells and G [gastrin] cells are present, was measured in resected stomachs from 42 patients (12 with gastric ulcer, 11 with duodenal ulcer, 14 with duodenal ulcer and uremia, and 5 with gastric cancer). Wide variation in the mucosal surface area corresponding to this zone was found (observed range: 0-43 cm2). Among 15 subjects showing a small transitional zone (0-5 cm2), most were patients with gastric ulcer. Among 14 patients with a medium size zone (6-20 cm2), those with duodenal ulcer predominated. Among 13 patients with a large zone (> 20 cm2), the majority had duodenal ulcer and uremia. Medium and large transitional zones were associated with high acid output and high parietal-cell density in the gastric body mucosa, whereas there was no relationship to the antral density or distribution of G cells. In transitional zones of medium or large size the average density of G cells was about 68% of that in the complete antrum, and the average parietal-cell density was about 24% of that in the body mucosa. The G cells and parietal cells in this zone were usually confined to different gland tubuli, but they were occasionally located adjacent to each other. In wide zones especially, the parietal cells commonly appeared bizarre, with varying size and shape, often showing vacuolization or condensed cytoplasm, whereas parietal cells in the body of the same stomachs showed normal morphology. The bizarre appearance of the parietal cells might be due to paracrine stimulation from the surrounding G cells.