Brief Article
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World J Gastroenterol. Dec 28, 2010; 16(48): 6151-6154
Published online Dec 28, 2010. doi: 10.3748/wjg.v16.i48.6151
Short-segment Barrett’s esophagus and cardia intestinal metaplasia: A comparative analysis
Ying Chang, Bin Liu, Gui-Sheng Liu, Tao Wang, Jun Gong
Ying Chang, Digestive Endoscopic Center, Shanghai Sixth Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
Bin Liu, Department of Emergence Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Gui-Sheng Liu, Department of Gastroenterology, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Tao Wang, Department of Gastroenterology, First Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Jun Gong, Department of Gastroenterology, Second Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Author contributions: Chang Y and Gong J designed the research; Chang Y, Liu B, Liu GS and Wang T performed the research; Chang Y, Liu GS and Wang T analyzed the data; Chang Y and Liu GS wrote the paper.
Supported by The Medical and Technology Cross Foundation of Shanghai Jiao Tong University, No. YG2010MS44
Correspondence to: Dr. Ying Chang, Digestive Endoscopic Center, Shanghai Sixth Hospital, Shanghai Jiao Tong University, Yishan Road 600, Shanghai 200233, China. mulan929@hotmail.com
Telephone: +86-21-64369181 Fax: +86-21-64369181
Received: August 30, 2010
Revised: September 26, 2010
Accepted: October 3, 2010
Published online: December 28, 2010
Abstract

AIM: To investigate the endoscopy and histology of short-segment Barrett’s esophagus (SSBE) and cardia intestinal metaplasia (CIM), and their correlation with Helicobacter pylori (H. pylori) gastritis and gastroesophageal reflux disease (GERD).

METHODS: Biopsy specimens were taken from 32 SSBE patients and 41 CIM patients with normal appearance of the esophagogastric junction. Eight biopsy specimens from the lower esophagus, cardia, and gastric antrum were stained with hematoxylin/eosin, Alcian blue/periodic acid-Schiff, Alcian blue/high iron diamine and Gimenez dye. Results were graded independently by one pathologist.

RESULTS: The SSBE patients were younger than the CIM patients (P < 0.01). The incidence of dysplasia and incomplete intestinal metaplasia subtype was higher in SSBE patients than in CIM patients (P < 0.01). H. pylori infection was correlated with antral intestinal metaplasia (P < 0.05), but not with reflux symptomatic, endoscopic, or histological markers of GERD in CIM patients. SSBE was correlated with reflux symptomatic and endoscopic esophagitis (P < 0.01), but not with H. pylori infection and antral intestinal metaplasia.

CONCLUSION: Dysplasia risk is significantly greater in SSBE patients than in CIM patients. CIM is a manifestation of H. pylori-associated and multifocal atrophic gastritis, whereas SSBE may result from GERD.

Keywords: Endoscopy, Barrett’s esophagus, Cardia intestinal metaplasia, Esophagogastric junction, Gastroesophageal reflux disease