<prompt> Which of the following is the most significant factor for development of gastric carcinoma?paneth cell metaplasiaPyloric metaplasiaIntestinal metaplasiaCiliated metaplasia  <response>: There are some conditions of pre-malignant changes in the gastric mucosa which have increased risk to the development of gastric cancer: I hypo- or achlorhydria in atrophic gastritis of gastric mucosa with intestinal metaplasia. iiAdenomatous neoplastic polyps of the stomach. iiiChronic gastric ulcer ulcer-cancer, and its association with achlorhydria. iv Stump carcinoma in patients who have undergone paial gastrectomy. TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:555 