title: Heterotopic gastric mucosa of the gastrointestinal tract: prevalence, histological features, and clinical characteristics.
abstract: BACKGROUND
  Heterotopic gastric mucosa (HGM) may be located at sites throughout the gastrointestinal (GI) tract. Clinical characteristics of HGM, role of Helicobacter pylori infection, natural history, and relationship to neoplastic transformation have not sufficiently been explored.
  
  
  OBJECTIVE
  To retrospectively study the prevalence, histological features, and clinical characteristics of HGM among Chinese patients who underwent upper GI endoscopy.
  
  
  METHODS
  Endoscopic, histological, and clinical records of patients, who underwent upper GI endoscopy (n = 6802) and colonoscopy (n = 3504), respectively, between May 2011 and May 2012, were collected and retrospectively analyzed. A total of 6716 sex- and age-matched patients without HGM were enrolled as controls.
  
  
  RESULTS
  HGM was diagnosed in 86 cases (51 esophageal, 0.75%; 35 duodenal, 0.51%). Male:female ratio was 1.4:1 (30/21) for esophageal HGM, 1.7:1 (22/13) for duodenal HGM, and 1.1:1 (3557/3159) for controls. Two histopathological types of HGM were identified: foveolar epithelium alone and foveoloar epithelium together with gastric glands. Helicobacter pylori were present in 19.6% of cases with esophageal HGM and 20.0% of cases with duodenal HGM. Esophageal HGM was significantly associated with dysphagia and globus; duodenal HGM was not significantly associated with GI symptoms. Intestinal metaplasia was present in two and three patients in both groups, respectively, with no dysplasia or carcinoma.
  
  
  CONCLUSIONS
  HGM was present in fewer patients undergoing upper GI endoscopy, and it was more often present in men. A careful endoscopic examination is required to diagnose HGM, and it should be supported with a biopsy when indicated.
authors.affiliation: Department of Gastroenterology and Hepatology, Chinese PLA General Hospital , Beijing , China.
authors.forename: Lan
authors.initials: L
authors.lastname: Yu
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Yang
authors.forename: Lihong
authors.initials: L
authors.lastname: Cui
authors.forename: Lihua
authors.initials: L
authors.lastname: Peng
authors.forename: Gang
authors.initials: G
authors.lastname: Sun
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D002828:Choristoma / Q000453:epidemiology* / Q000473:pathology; D003680:Deglutition Disorders / Q000209:etiology; D004378:Duodenal Diseases / Q000453:epidemiology* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004935:Esophageal Diseases / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies