简介：可塑性是正常胃肠道的固有特性，允许适当地应对伤害和治愈。然而，可适应反应的异常性质也开始被认为是癌症发展和进展的驱动力。胃和食管恶性肿瘤仍然是全球癌症相关死亡的主要原因，因为早期疾病诊断工具有限，新的有效治疗方法也不多。胃和食管腺癌都共享肠化前癌病变作为一个重要的前体病变。方法：在这里，我们利用一组上消化道患者来源的组织微阵列，涵盖从正常组织到癌症的序贯发展，以展示一组肠化标记物的表达。结果：与具有不完全和完全肠化特征的胃肠化前病变不同，Barrett食管（即食管肠化前病变）表现出不完全肠化的特征。具体而言，这种普遍存在于Barrett食管中的不完全肠化表现为同时发展和表达胃和肠道特征。此外，许多胃和食管癌症展示了这些特征分化细胞性质的丧失或减少，表明这些癌症发展所涉及的分子途径的可塑性。讨论：进一步了解上消化道肠化病变的发展及其进展到癌症的共性和差异，将引导改进诊断和治疗方法。版权所有©2023 Zeng，Li，Roy，Mills和Jin。

Introduction: Plasticity is an inherent property of the normal gastrointestinal tract allowing for appropriate response to injury and healing. However, the aberrancy of adaptable responses is also beginning to be recognized as a driver during cancer development and progression. Gastric and esophageal malignancies remain leading causes of cancer-related death globally as there are limited early disease diagnostic tools and paucity of new effective treatments. Gastric and esophageal adenocarcinomas share intestinal metaplasia as a key precancerous precursor lesion. Methods: Here, we utilize an upper GI tract patient-derived tissue microarray that encompasses the sequential development of cancer from normal tissues to illustrate the expression of a set of metaplastic markers. Results: We report that in contrast to gastric intestinal metaplasia, which has traits of both incomplete and complete intestinal metaplasia, Barrett's esophagus (i.e., esophageal intestinal metaplasia) demonstrates hallmarks of incomplete intestinal metaplasia. Specifically, this prevalent incomplete intestinal metaplasia seen in Barrett's esophagus manifests as concurrent development and expression of both gastric and intestinal traits. Additionally, many gastric and esophageal cancers display a loss of or a decrease in these characteristic differentiated cell properties, demonstrating the plasticity of molecular pathways associated with the development of these cancers. Discussion: Further understanding of the commonalities and differences governing the development of upper GI tract intestinal metaplasias and their progression to cancer will lead to improved diagnostic and therapeutic avenues.Copyright © 2023 Zeng, Li, Roy, Mills and Jin.