Ying Chang1, Bin Liu, Gui-Sheng Liu, Tao Wang, Jun Gong. 1. Digestive Endoscopic Center, Shanghai Sixth Hospital, Shanghai Jiao Tong University, Yishan Road 600, Shanghai 200233, China. mulan929@hotmail.com
Abstract
AIM: to investigate the endoscopy and histology of short-segment Barrett's esophagus (SSBE) and cardia intestinal metaplasia (CIM), and their correlation with Helicobacter pylori (H. pylori) gastritis and gastroesophageal reflux disease (GERD). METHODS: biopsy specimens were taken from 32 SSBE patients and 41 CIM patients with normal appearance of the esophagogastric junction. Eight biopsy specimens from the lower esophagus, cardia, and gastric antrum were stained with hematoxylin/eosin, Alcian blue/periodic acid-Schiff, Alcian blue/high iron diamine and Gimenez dye. Results were graded independently by one pathologist. RESULTS: the SSBE patients were younger than the CIM patients (P < 0.01). The incidence of dysplasia and incomplete intestinal metaplasia subtype was higher in SSBE patients than in CIM patients (P < 0.01). H. pylori infection was correlated with antral intestinal metaplasia (P < 0.05), but not with reflux symptomatic, endoscopic, or histological markers of GERD in CIM patients. SSBE was correlated with reflux symptomatic and endoscopic esophagitis (P < 0.01), but not with H. pylori infection and antral intestinal metaplasia. CONCLUSION: dysplasia risk is significantly greater in SSBE patients than in CIM patients. CIM is a manifestation of H. pylori-associated and multifocal atrophic gastritis, whereas SSBE may result from GERD.
AIM: to investigate the endoscopy and histology of short-segment Barrett's esophagus (SSBE) and cardia intestinal metaplasia (CIM), and their correlation with Helicobacter pylori (H. pylori) gastritis and gastroesophageal reflux disease (GERD). METHODS: biopsy specimens were taken from 32 SSBE patients and 41 CIMpatients with normal appearance of the esophagogastric junction. Eight biopsy specimens from the lower esophagus, cardia, and gastric antrum were stained with hematoxylin/eosin, Alcian blue/periodic acid-Schiff, Alcian blue/high iron diamine and Gimenez dye. Results were graded independently by one pathologist. RESULTS: the SSBE patients were younger than the CIMpatients (P < 0.01). The incidence of dysplasia and incomplete intestinal metaplasia subtype was higher in SSBE patients than in CIMpatients (P < 0.01). H. pyloriinfection was correlated with antral intestinal metaplasia (P < 0.05), but not with reflux symptomatic, endoscopic, or histological markers of GERD in CIMpatients. SSBE was correlated with reflux symptomatic and endoscopic esophagitis (P < 0.01), but not with H. pyloriinfection and antral intestinal metaplasia. CONCLUSION:dysplasia risk is significantly greater in SSBE patients than in CIMpatients. CIM is a manifestation of H. pylori-associated and multifocal atrophic gastritis, whereas SSBE may result from GERD.
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