Short segments of Barrett's epithelium and intestinal metaplasia in normal appearing oesophagogastric junctions: the same or two different entities?
BACKGROUND
Endoscopic diagnosis of short segments of Barrett's epithelium (SSBE)' is difficult and its meaning in terms of the presence of specialised columnar epithelium (SCE) has not been prospectively evaluated.


OBJECTIVE
To evaluate the prevalence of SCE in patients with an endoscopic diagnosis of SSBE and in individuals with normal appearing oesophagogastric junctions, and to compare the clinical characteristics of these two groups.


METHODS
Thirty one patients with an endoscopic diagnosis of short Barrett's oesophagus, less than 3 cm in length (group A), and 44 consecutive patients with normal appearing oesophagogastric junctions (group B).


METHODS
Multiple biopsies were performed in suspicious epithelium and at the oesophagogastric junction in groups A and B, respectively.


RESULTS
Age and sex distribution were similar in both groups. Reflux symptoms were more frequent in group A (p < 0.001), as were endoscopic and histological signs of oesophagitis (p < 0.001 and p = 0.001, respectively). SCE was found in 61.3% of group A patients compared with 25% in group B (p < 0.002), with men predominating in group A while women were more frequent in group B (p = 0.02). The differences in reflux symptoms and endoscopic/histological oesophagitis remained significant.


CONCLUSIONS
These results show that endoscopic diagnosis of SSBE is associated with a high prevalence of SCE, significantly higher than that found in normal appearing oesophagogastric junctions. Differences between patients with SCE in the two groups suggest they may represent two different entities.
Pereira
A D
AD
Gastroenterology Department, Instituto Português de Oncologia Francisco Gentil, Lisboa, Portugal.
Suspiro
A
A
Chaves
P
P
Saraiva
A
A
Glória
L
L
de Almeida
J C
JC
Leitão
C N
CN
Soares
J
J
Mira
F C
FC
D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D001706:Biopsy; D004848:Epithelium / Q000473:pathology; D004943:Esophagogastric Junction / Q000473:pathology*; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000473:pathology; D006801:Humans; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011446:Prospective Studies