title: Clinical evaluation of twenty cases of heterotopic gastric mucosa of upper esophagus during five-year observation, using gastroscopy in combination with histopathological and microbiological analysis of biopsies.
abstract: OBJECTIVE
  Heterotopic gastric mucosa of the upper esophagus (HGMUE) may be connected with disorders of the upper gastrointestinal tract, exacerbated by Helicobacter pylori. Furthermore, HGMUE may be the origin of malignant progression to cervical esophageal carcinoma.
  
  
  METHODS
  In this work, 20 patients with diagnosed heterotopic gastric mucosa of the upper esophagus (HGMUE) were subjected to 5-year follow-up to determine the extent and structure of histopathological changes within HGMUEs, as well as HGMUE dysplasia and metaplasia, and risk of their malignant transformation. As a diagnostic tool to describe localization, form, size and surface feature of HGMUEs, endoscopy was used. At the same time, the biopsies were collected for histopathological and microbiological analysis.
  
  
  RESULTS
  In examined patients, HGMUEs were associated with inflammation, chronic gastritis, hiatus hernia, duodenal bulb erosion and ulcer and infection of H. pylori. Intestinal metaplasia and low grade dysplasia were also indicated. During 5 years of observation, both the clinical and histopathological image of diagnosed HGMUEs was stable. The patients with detected presence of H. pylori were treated with triple or quadruple therapy. These results show that HGMUEs may be associated with severe complications in the gastrointestinal tract, such as infection by H. pylori, hiatus hernia or duodenal ulcer. Although dysplasias and metaplasias found in diagnosed HGMUEs were not very numerous and relatively stable both clinically and histopathologically, at the present stage of the study we cannot exclude the possibility of HGMUE malignant transformation.
authors.affiliation: Department and Clinic of Internal Diseases, Angiology and Physical Medicine in Bytom, Medical University of Silesia, Katowice, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Latos
authors.forename: Karolina
authors.initials: K
authors.lastname: Sieroń-Stołtny
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kawczyk-Krupka
authors.forename: Tomasz
authors.initials: T
authors.lastname: Operchalski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Cieślar
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kwiatek
authors.forename: Andrzej M
authors.initials: AM
authors.lastname: Bugaj
authors.forename: Aleksander
authors.initials: A
authors.lastname: Sieroń
keywords: dysplasia; esophagus; heterotopic gastric mucosa; malignant transformations; metaplasia