Is intestinal metaplasia the point of no return in the progression of gastric carcinogenesis?

Gastric cancer(GC)is one of the most common malignant tumors worldwide.In China,GC is the second most common malignant tumor,and it is the second leading cause of cancer mortality.[1]Correa model showed that the development of intestinal-type GC was a consecutive cancerous process including normal gastric mucosa,non-atrophic gastritis,atrophic gastritis(AG),intestinal metaplasia(IM),dysplasia and intestinal-type GC in sequence.[2]Epithelium-resembling intestinal morphology replaced gastric mucosa which was defined as IM.[3]Among these precancerous conditions,IM was demonstrated to be a vital risk factor for GC,especially incomplete IM and extensive IM.[4,5].