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Two precancerous metaplasias relevant to gastric malignancy are intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia (SPEM). Growing evidence highlights SPEM’s involvement in gastric carcinogenesis and its association with early-stage human disease. This review summarizes SPEM roles and research progress toward clarifying mechanisms and clinical implications.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/role-and-research-progress-of-spasmolytic-polypeptide-expressing-metaplasia-in-gastric-cancer-review/326845/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/role-and-research-progress-of-spasmolytic-polypeptide-expressing-metaplasia-in-gastric-cancer-review/326845.png","ImageObject",300,407,{"name":92,"@type":93},"Himbo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is spasmolytic polypeptide-expressing metaplasia (SPEM) and why is it important in gastric cancer?","Question",{"text":113,"@type":114},"SPEM is a precancerous metaplasia associated with gastric malignancies. Recent evidence links SPEM to the induction of gastric cancer and to early-stage human gastric cancer.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How does the article describe the progression to gastric cancer?",{"text":118,"@type":114},"Gastric cancer does not occur suddenly; it is preceded by progressive changes including gastritis, atrophy, metaplasia, dysplasia, and carcinogenesis.",{"name":120,"@type":111,"acceptedAnswer":121},"What are the two types of precancerous metaplasia discussed in relation to gastric malignancies?",{"text":122,"@type":114},"The article discusses intestinal metaplasia (IM) and spasmolytic polypeptide-expressing metaplasia (SPEM) as the two identified precancerous metaplasias related to gastric cancers.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},326845,1790125992,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":41,"preview_page_count":4},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","INTERNATIONAL JOURNAL OF ONCOLOGY 64: 33, 2024  \nRole and research progress of spasmolytic polypeptide‑expressing  \nmetaplasia in gastric cancer (Review)  \nYANG CHONG 1,2 , DONG YU 1,2 , ZHAOYU LU 1,2 and FENGSONG NIE 1,2  \nDepartments of 1Traditional Chinese Medicine and 2General Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu 225000, P.R. China  \nReceived October 10, 2023; Accepted December 20, 2023  \nDOI: 10.3892/ijo.2024.5621  \nAbstract. Gastric cancer ranks as one of the most prevalent cancers worldwide. While the incidence of gastric cancer in Western countries has notably diminished over the past century, it continues to be a leading cause of cancer‑related mortality on a global scale. The majority of gastric cancers in humans are attributed to chronic Helicobacter pylori infec‑ tion and the progression of gastric cancer is often preceded by gastritis, atrophy, metaplasia and dysplasia . However, the precise mechanisms underlying the development of gastric cancer remain ambiguous, including the formation of gastric polyps and precancerous lesions . In humans, two types of precancerous metaplasia have been identified in relation to gastric malignancies: Intestinal metaplasia and spasmolytic polypeptide‑expressing metaplasia (SPEM). The role of SPEMin the induction of gastric cancer has gained recent attention and its link with early‑stage human gastric cancer is increas‑ ingly evident. To gain insight into SPEM, the present study reviewed the role and research progress of SPEM in gastric cancer.  \nContents  \n1. Introduction  \n2. SPEM‑discovery and overview  \n3. Damage repair of the stomach  \n4. Oxyntic atrophy, inflammation, metaplasia and gastric cancer  \n5. Metaplasia origin  \n6. Effects of cytokines on metaplasia  \nCorrespondence to: Dr Yang Chong, Department of Traditional Chinese Medicine, The Affiliated Hospital of Yangzhou University, Yangzhou University, 368 Hanjiang Middle Road, Hanjiang, Yangzhou, Jiangsu 225000, P.R. China  \nE‑mail: [092016@yzu.edu.cn](092016@yzu.edu.cn)  \nKey words: spasmolytic polypeptide‑expressing metaplasia, gastric cancer, oxyntic atrophy, inflammation, cytokines  \n7. Metaplasia and other factors may further lead to gastric cancer  \n8. Conclusions and future outlook  \n1. Introduction  \nAccording to global cancer statistics for 2020, the incidence and mortality rates of gastric cancer were the fifth and fourth highest, respectively, among common cancers. In China, the incidence and mortality rates of gastric cancer were both the third highest among all cancers (1) . However, the occurrence of gastric cancer has not been studied in depth, and its devel‑ opment is preceded by a series of progressive changes, namely gastritis, atrophy, metaplasia, dysplasia and carcinogenesis (2) . Metaplasia is defined as the replacement of a differentiated cell type by another mature differentiated cell type that isnot normally present in a given tissue (3) . In humans, two types of precancerous metaplasia are associated with gastric cancer, namely intestinal metaplasia (IM) and spasmolytic polypeptide‑expressing metaplasia (SPEM) . SPEM, also known as pseudopyloric metaplasia or mucinous metaplasia, is represented by morphological features of the deep antral gland or Brunner's glands and expresses trefoil factor 2 (TFF2) and mucin 6 (MUC6) (4,5) . IM is often considered a result of the transdifferentiation of mucosa into an intestinal phenotype, which appears to be associated with chronic inflammation (6) and is characterized by the presence of mucin‑containing goblet cells, Paneth cells and absorptive cells and by the expres‑ sion of TFF3 and MUC2 (7,8) . Another member of the trefoil protein family, TFF1, is mainly secreted in gastric foveolar cells (9) and has a crucial role in gastrointestinal epithelium repair (10) . The precise association between SPEM and IM and their origins warrant further exploration in large‑scale clinical studies.  \n2. SPEM‑disco","cbCaiiWvWN4s8wgY","https://ap.wps.com/l/cbCaiiWvWN4s8wgY","pdf",930736,12,"English","# Introduction\n# SPEM-discovery and overview\n# Damage repair of the stomach\n# Oxyntic atrophy, inflammation, metaplasia and gastric cancer\n# Metaplasia origin\n# Effects of cytokines on metaplasia\n# Metaplasia and other factors may further lead to gastric cancer\n# Conclusions and future outlook","[{\"question\":\"What is spasmolytic polypeptide-expressing metaplasia (SPEM) and why is it important in gastric cancer?\",\"answer\":\"SPEM is a precancerous metaplasia associated with gastric malignancies. Recent evidence links SPEM to the induction of gastric cancer and to early-stage human gastric cancer.\"},{\"question\":\"How does the article describe the progression to gastric cancer?\",\"answer\":\"Gastric cancer does not occur suddenly; it is preceded by progressive changes including gastritis, atrophy, metaplasia, dysplasia, and carcinogenesis.\"},{\"question\":\"What are the two types of precancerous metaplasia discussed in relation to gastric malignancies?\",\"answer\":\"The article discusses intestinal metaplasia (IM) and spasmolytic polypeptide-expressing metaplasia (SPEM) as the two identified precancerous metaplasias related to gastric cancers.\"}]","Role and research progress of spasmolytic polypeptide-expressing metaplasia in gastric cancer - Review | PDF",1789975535]