Intestinal metaplasia of the esophagus or esophagogastric junction: evidence of distinct clinical, pathologic, and histochemical staining features.
Our purpose was to evaluate the clinical, histologic, and histochemical staining characteristics of intestinal metaplasia (IM) at an endoscopically normal-appearing esophagogastric junction (IM-EGJ) compared with IM in a columnar-lined esophagus (IM-CLE). A prospective study included 253 patients referred for elective upper gastrointestinal endoscopy. Biopsy specimens were obtained from 2 cm above and immediately distal to the squamocolumnar junction, the gastric corpus, and the antrum. Any red mucosa above the EGJ was sampled. IM-CLE (prevalence, 5.5%) typically occurred in white male smokers with a long history of reflux symptoms. IM-EGJ (prevalence, 9.1%) was associated with corpus and antrum gastritis and with IM at these sites. IM-CLE usually (13/14 [93%]) was the incomplete type IM, whereas only 12 (52%) of 23 patients in the IM-EGJ group had incomplete IM. IM-EGJ and IM-CLE should be considered as separate entities. Further research is needed to evaluate whether neoplastic progression of IM-EGJ is related to its mucin profile.
van Sandick
Johanna W
JW
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
van Lanschot
Jan B
JB
van Felius
Lonneke
L
Haringsma
Jelle
J
Tytgat
Guido N J
GN
Dekker
Wim
W
Drillenburg
Paul
P
Offerhaus
G Johan A
GJ
ten Kate
Fiebo J W
FJ
D000230:Adenocarcinoma / Q000209:etiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000150:complications / Q000473:pathology*; D004938:Esophageal Neoplasms / Q000209:etiology / Q000473:pathology*; D004943:Esophagogastric Junction / Q000473:pathology*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D009077:Mucins / Q000032:analysis*; D015995:Prevalence; D012307:Risk Factors; D013194:Staining and Labeling
D009077:Mucins