Intestinal metaplasia at the squamocolumnar junction in patients attending for diagnostic gastroscopy
Intestinal metaplasia at the squamocolumnar junction in patients attending for diagnostic gastroscopy
复制标题
接受诊断性胃镜检查的患者鳞柱交界处的肠化生
作者：
N. J. Trudgill;S K Suvarna;K C Kapur;S. A. Riley
食管和贲门腺癌的发病率正在迅速增加。巴雷特食管是主要的危险因素。在没有Barrett食管的情况下，鳞柱状交界处的肠上皮化生很常见，但其与腺癌和胃食管反流病的关系尚不清楚。目的：研究鳞状上皮-柱状上皮交界处肠上皮化生的患病率、临床、内镜和组织学相关性。方法：从120例随机选择的接受常规诊断性内窥镜检查的患者中采集活检标本。从鳞状柱状交界处、胃底和胃窦上下取8份活检标本，用苏木精/伊红、阿辛蓝/高碘酸-希夫和Gimenez染色，并由一名病理学家独立分级。结果：21例患者（18%）在鳞柱状交界处发现肠上皮化生。化生与年龄增加（p<0.01）和胃窦肠化生（p=0.04）相关。Logistic回归分析显示年龄是唯一的独立预测因素（p<0.01）。与胃食管反流病的症状、内镜或组织学标志物无关。结论：鳞状柱状交界处的肠上皮化生是一种常见的发现。它与年龄增长有关，但与胃食管反流病无关。
Background—The incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing rapidly. Barrett’s oesophagus is the major risk factor. Intestinal metaplasia at the squamocolumnar junction in the absence of Barrett’s oesophagus is common but its relation to adenocarcinoma and gastro-oesophageal reflux disease is unclear. Aims—To study the prevalence and clinical, endoscopic, and histological associations of intestinal metaplasia at the squamocolumnar junction. Methods—Biopsy specimens were taken from 120 randomly selected patients undergoing routine diagnostic endoscopy. Eight biopsy specimens, taken from above and below the squamocolumnar junction, gastric fundus, and gastric antrum, were stained with haematoxylin/eosin, alcian blue/periodic acid-Schiff, and Gimenez, and graded independently by one pathologist. Results—Intestinal metaplasia at the squamocolumnar junction was found in 21 patients (18%). Metaplasia was associated with increasing age (p<0.01) and antral intestinal metaplasia (p=0.04). Logistic regression analysis revealed that age was the only independent predictor (p<0.01). There was no association with symptomatic, endoscopic, or histological markers of gastro-oesophageal reflux disease. Conclusions—Intestinal metaplasia at the squamocolumnar junction is a common finding. It is associated with increasing age but not gastro-oesophageal reflux disease.