<prompt> Which one of the following is the most significant risk factor for development of gastric carcinoma?Paneth cell metaplasiaPyloric metaplasiaIntestinal metaplasiaCiliated metaplasia  <response>: Risk factors are:Long-term ingestion of high concentration of nitratesH.pyloriIntestinal metaplasia in patients with atrophic gastritisGastric ulcers and adenomatous polypsMenetriers diseasePatients with blood group A have a higher incidence of Ca stomach than blood group ONote: duodenal ulcers are not associated with gastric cancer.Ref: Harrisons 18e p766 