title: Intestinal metaplasia in Barrett's oesophagus: An essential factor to predict the risk of dysplasia and cancer development.
abstract: BACKGROUND
  To date, there is still uncertainty on the role of specialized intestinal metaplasia in the carcinogenic process of Barrett's oesophagus (BE); this fact seems of importance for planning adequate surveillance programs.
  
  
  OBJECTIVE
  To predict the risk of progression towards dysplasia/cancer based on typical morphological features by evaluating the importance of intestinal metaplasia in BE patients.
  
  
  METHODS
  647 cases with a histological diagnosis of BE, referred to the Endoscopy Unit of a tertiary centre between 2000 and 2012 were retrospectively identified, and divided into two groups according to the presence/absence of intestinal metaplasia. For each patient, all histological reports performed during a follow-up of 4-8 years were analyzed.
  
  
  RESULTS
  Overall, 537 cases (83%) with intestinal metaplasia and 110 cases (17%) without intestinal metaplasia were included. During the follow-up period, none of the patients without intestinal metaplasia developed dysplasia/cancer nor progressed to metaplasia, whereas 72 patients with intestinal metaplasia (13.4%) showed histological progression of the disease.
  
  
  CONCLUSIONS
  The histological identification of intestinal metaplasia seems to be an essential factor for the progression towards dysplasia and cancer in BE patients.
authors.affiliation: Institute of Pathology, Spedali Civili, Brescia, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Salemme
authors.affiliation: Institute of Pathology, Spedali Civili, Brescia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Villanacci
authors.affiliation: Department of Surgery and Endoscopy Unit, University of Brescia, Spedali Civili, Brescia, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Cengia
authors.affiliation: Department of Surgery and Endoscopy Unit, University of Brescia, Spedali Civili, Brescia, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Cestari
authors.affiliation: Department of Surgery and Endoscopy Unit, University of Brescia, Spedali Civili, Brescia, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Missale
authors.affiliation: Gastroenterology Section, Department of Medicine, University of Perugia School of Medicine, Perugia, Italy. Electronic address: gabassot@tin.it.
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011230:Precancerous Conditions / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk; D055815:Young Adult
keywords: Barrett's oesophagus; Cancer development; Endoscopy; Intestinal metaplasia