Characteristics of intestinal metaplasia in the gastric cardia
Characteristics of intestinal metaplasia in the gastric cardia
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DOI：
10.1016/s0002-9270(98)00805-3
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发表时间：
1999-03-01
影响因子：
9.8
通讯作者：
Feddersen, RM
中科院分区：
文献类型：
--
作者：
El-Serag, HB;Sonnenberg, A;Feddersen, RM
目的：胃食管交界处的肠上皮化生常与巴雷特食管合并。胃食管交界区由远端食管和贲门组成。本研究的目的是评估是否在远端食管和贲门肠上皮化生代表两个不同的实体与一组不同的风险factors.METHODS：择期胃镜检查的患者被纳入一项前瞻性研究。在胃窦、胃体和贲门的胃活检中评价胃炎和肠上皮化生的存在。Barrett食管的定义是存在任何长度的柱状粘膜以上的胃食管junction.Results：302例患者中，50例有肠上皮化生的贲门，73 Barrett食管，116糜烂性食管炎。男性比女性更容易患巴雷特食管或糜烂性食管炎。这两种情况在白人中也比非白人更常见。吸烟在巴雷特食管患者中特别常见。贲门肠上皮化生患者不具有这些人口统计学特征。每日反流症状、糜烂性食管炎和Barrett食管的患病率在有和无贲门肠上皮化生的患者中相似。然而，萎缩和肠上皮化生的胃窦和胃体被发现更频繁的患者比没有贲门肠上皮化生。结论：肠上皮化生的贲门是不同的巴雷特食管。虽然贲门肠上皮化生与胃其他部位的胃炎体征密切相关，但胃食管反流病似乎不是一个危险因素。Barrett食管的诊断不应基于胃食管交界处贲门部肠上皮化生的存在。(Am胃肠病学杂志1999; 94：622-627. (C)1999年，我Cell.胃肠病学）。
OBJECTIVE: Intestinal metaplasia of the gastroesophageal junction is frequently grouped together with Barrett's esophagus. The area of the gastroesophageal junction is comprised of the distal esophagus and the gastric cardia. The aim of the present study was to assess whether intestinal metaplasia in the distal esophagus and gastric cardia represent two different entities with a different set of risk factors.METHODS: Patients presenting for elective upper endoscopy were enrolled into a prospective study. The presence of gastritis and intestinal metaplasia was evaluated in gastric biopsies taken from the antrum, corpus, and cardia. Barrett's esophagus was defined by the presence of any length of columnar mucosa above the gastroesophageal junction.RESULTS: Of 302 patients, 50 patients had intestinal metaplasia of the gastric cardia, 73 Barrett's esophagus, and 116 erosive esophagitis. Men were more prone than women to develop Barrett's esophagus or erosive esophagitis. Both conditions were also more common among whites than nonwhites. Smoking was particularly common among patients with Barrett's esophagus. Patients with cardiac intestinal metaplasia did not share these demographic characteristics. The prevalence of daily reflux symptoms, erosive esophagitis, and Barrett's esophagus was similar among patients both with and without cardiac intestinal metaplasia. However, atrophy and intestinal metaplasia of the gastric antrum and corpus were found more frequently among patients with than without cardiac intestinal metaplasia.CONCLUSIONS: Intestinal metaplasia of the gastric cardia is different from Barrett's esophagus. Although cardiac intestinal metaplasia is closely associated with signs of gastritis in other parts of the stomach, gastroesophageal reflux disease does not seem to be a risk factor. A diagnosis of Barrett's esophagus should not be made based on the presence of intestinal metaplasia within the cardiac portion of the gastroesophageal junction. (Am J Gastroenterol 1999; 94:622-627. (C) 1999 by Am. Cell. of Gastroenterology).