title: Intestinal metaplasia of the esophagus or esophagogastric junction: evidence of distinct clinical, pathologic, and histochemical staining features.
abstract: 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.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Johanna W
authors.initials: JW
authors.lastname: van Sandick
authors.forename: Jan B
authors.initials: JB
authors.lastname: van Lanschot
authors.forename: Lonneke
authors.initials: L
authors.lastname: van Felius
authors.forename: Jelle
authors.initials: J
authors.lastname: Haringsma
authors.forename: Guido N J
authors.initials: GN
authors.lastname: Tytgat
authors.forename: Wim
authors.initials: W
authors.lastname: Dekker
authors.forename: Paul
authors.initials: P
authors.lastname: Drillenburg
authors.forename: G Johan A
authors.initials: GJ
authors.lastname: Offerhaus
authors.forename: Fiebo J W
authors.initials: FJ
authors.lastname: ten Kate
mesh_terms: 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
chemical_list: D009077:Mucins