BACKGROUND: Intestinal metaplasia (IM) in the oesophagus is a known risk factor for adenocarcinoma of the oesophagus. The incidence of adenocarcinoma of the cardia and oesophagus has increased in Western countries simultaneously with a decrease in Helicobacter pylori prevalence. AIMS: To determine the association of H pylori infection with inflammation and IM at the squamocolumnar junction (SCJ) in young individuals. PATIENTS: A total of 168 (121 women; 72%) consecutive outpatients, </=45 years, undergoing gastroscopy, and with no prior H pylori eradication treatment. METHODS: Biopsy specimens taken from the antrum, corpus, SCJ, and oesophagus were assessed according to the updated Sydney system, and type of IM (complete or incomplete) was determined. Serum samples from H pylori positive patients were studied for CagA antibodies. RESULTS: In 86% of 37 patients with gastritis in the antrum and/or corpus (24 histologically H pylori positive) and in 23% of 125 patients with a healthy stomach, inflammation was present in the glandular mucosa at the SCJ. In the latter, cardiac mucosa more often than fundic mucosa at the SCJ was inflamed (p<0.001), the inflammation was usually milder in nature, and was associated with signs of reflux disease. IM (incomplete or complete) at the SCJ was evident in nine of those 24 with a healthy stomach and inflamed cardiac mucosa at the SCJ but in none of those with H pylori gastritis. CONCLUSIONS: IM at the SCJ can also appear in young individuals in whom it seems to be associated with reflux related isolated inflammation in cardiac mucosa at the SCJ but not with H pylori gastritis.
BACKGROUND: Intestinal metaplasia (IM) in the oesophagus is a known risk factor for adenocarcinoma of the oesophagus. The incidence of adenocarcinoma of the cardia and oesophagus has increased in Western countries simultaneously with a decrease in Helicobacter pylori prevalence. AIMS: To determine the association of H pylori infection with inflammation and IM at the squamocolumnar junction (SCJ) in young individuals. PATIENTS: A total of 168 (121 women; 72%) consecutive outpatients, </=45 years, undergoing gastroscopy, and with no prior H pylori eradication treatment. METHODS: Biopsy specimens taken from the antrum, corpus, SCJ, and oesophagus were assessed according to the updated Sydney system, and type of IM (complete or incomplete) was determined. Serum samples from H pylori positive patients were studied for CagA antibodies. RESULTS: In 86% of 37 patients with gastritis in the antrum and/or corpus (24 histologically H pylori positive) and in 23% of 125 patients with a healthy stomach, inflammation was present in the glandular mucosa at the SCJ. In the latter, cardiac mucosa more often than fundic mucosa at the SCJ was inflamed (p<0.001), the inflammation was usually milder in nature, and was associated with signs of reflux disease. IM (incomplete or complete) at the SCJ was evident in nine of those 24 with a healthy stomach and inflamed cardiac mucosa at the SCJ but in none of those with H pylori gastritis. CONCLUSIONS: IM at the SCJ can also appear in young individuals in whom it seems to be associated with reflux related isolated inflammation in cardiac mucosa at the SCJ but not with H pylori gastritis.
Authors: P T Chandrasoma; D M Lokuhetty; T R Demeester; C G Bremmer; J H Peters; S Oberg; S Groshen Journal: Am J Surg Pathol Date: 2000-03 Impact factor: 6.394
Authors: M Conio; A J Cameron; Y Romero; C D Branch; C D Schleck; L J Burgart; A R Zinsmeister; L J Melton; G R Locke Journal: Gut Date: 2001-03 Impact factor: 23.059
Authors: S P Kilgore; A H Ormsby; T L Gramlich; T W Rice; J E Richter; G W Falk; J R Goldblum Journal: Am J Gastroenterol Date: 2000-04 Impact factor: 10.864
Authors: Joseph Chok Yan Ip; Josephine Mun Yee Ko; Valen Zhuoyou Yu; Kwok Wah Chan; Alfred K Lam; Simon Law; Daniel King Hung Tong; Maria Li Lung Journal: Biomed Res Int Date: 2015-03-05 Impact factor: 3.411