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目的观察胃癌（ＧＣ）的发生过程．方法在胃癌高发区山东省临朐县，对一组有胃粘膜病理诊断结果的自然人群进行随访观察，并配以嵌套式病例对照研究．结果胃粘膜肠上皮化生（ＩＭ）和异型增生（Ｄｙｓ）发生胃癌的危险性显著高于慢性萎缩性胃炎（ＣＡＧ），且在胃中不同部位的检出率与胃癌在相应部位发生的频率存在正等级相关关系；Ｄｙｓ发生胃癌所需要的时间明显短于ＩＭ发生胃癌所需要的时间．结论胃癌特别是肠型胃癌是在ＣＡＧ基础上发生ＩＭ，进而产生Ｄｙｓ，最终导致癌变的一系列过程
Objective To observe the occurrence of gastric cancer (GC). Methods A group of natural populations with pathological diagnosis of gastric mucosa was followed up in Linyi County, Shandong Province, a high incidence area of gastric cancer, and a nested case-control study was performed. Results The risk of gastric cancer in intestinal metaplasia (IM) and dysplasia (Dys) was significantly higher than that in chronic atrophic gastritis (CAG), and the detection rate in different parts of the stomach and the frequency of gastric cancer in the corresponding sites. There is a positive grading correlation; the time required for Dys to develop gastric cancer is significantly shorter than the time required for IM to develop gastric cancer. Conclusion Gastric cancer, especially intestinal type gastric cancer, is a series of processes that cause IM on the basis of CAG, and then produce Dys, which eventually leads to canceration.