Prevalence and risk factors associated with specialized intestinal metaplasia at the esophagogastric junction.
OBJECTIVE
Specialized intestinal metaplasia around the esophagogastric junction is considered to be premalignant. The aim of this study was to examine prospectively the prevalence of metaplasia and to correlate its presence with clinical, endoscopic and histological findings.


METHODS
In 101 symptomatic patients (40 women, 61 men; mean age: 55 yr, range: 20-79 yr), biopsies were taken from gastric type mucosa just distal to the esophagogastric junction. They were stained with hematoxylin and eosin and alcian blue-periodic acid Schiff for the detection of specialized intestinal metaplasia and inflammation of the cardiac mucosa (carditis) and with Warthin-Starry for H. pylori presence.


RESULTS
Metaplasia was detected in 27 patients (26.7%). Multiple logistic regression analysis revealed that metaplasia was associated significantly with age (odds ratio, 2.8; 95% confidence interval, 1.2-6.6), endoscopic suspicion of short segment Barrett's esophagus (odds ratio, 3.6; 95% confidence interval 2.2-6.9), detection of H. pylori (odds ratio, 2.8; 95% confidence interval, 1.1-7) and presence of carditis (odds ratio, 6.4; 95% confidence interval, 2.8-16.8).


CONCLUSIONS
The prevalence of specialized intestinal metaplasia around the esophagogastric junction is high in symptomatic patients. Age, endoscopic evidence of short segment Barrett's esophagus and histological presence of H. pylori and carditis are independent risk factors associated with its presence.
Kamberoglou
D K
DK
Department of GI Endoscopy, 1st IKA Hospital of Athens, Department of Pathology, Amalia Fleming Hospital, Athens, Greece.
Savva
S C
SC
Kalapothakos
P N
PN
Koukounas
N D
ND
Doulgeroglou
V G
VG
Patra
E G
EG
Tzias
V D
VD
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000453:epidemiology / Q000473:pathology*; D001706:Biopsy; D002299:Cardia / Q000473:pathology; D003430:Cross-Sectional Studies; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D004943:Esophagogastric Junction / Q000473:pathology; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology*; D012307:Risk Factors