ISSN:
1573-2568
Keywords:
BARRETT'S ESOPHAGUS
;
GASTROESOPHAGEAL REFLUX DISEASE
;
SPECIALIZED INTESTINAL METAPLASIA
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Over the past two decades, the incidence ofadenocarcinoma of the esophagus and gastric cardia hasincreased at a rate exceeding that of any other cancer.Barrett's esophagus is the only known risk factor for these malignancies. Recently, emphasis hasbeen placed on the significance of specializedintestinal metaplasia (SIM) on esophageal biopsies. Ouraim was to compare the prevalence of SIM at different esophageal locations in patients who are athigher risk of developing esophageal adenocarcinoma(Caucasians) and patients with lower risk of developingesophageal adenocarcinoma (African-Americans).Eighty-seven unselected patients (42 Caucasians and 45African-Americans) underwent routine upper endoscopywith biopsies from the proximal margin of columnarmucosa. We classified patients into those with acolumnar-lined esophagus with SIM (CLE with SIM); CLE withoutSIM; or SIM with a normal-appearing gastroesophagealjunction (SIM-GEJ). The prevalence of CLE with SIM, CLEwithout SIM, and SIM-GEJ was 28%, 10%, and 10% in Caucasians compared to 0%, 18% and 11% inAfrican-Americans (P = 0.0001, 0.26, and 0.81,respectively). We found CLE with SIM only in patientswith reflux symptoms at least twice a week. It isconcluded that CLE with SIM is seen most commonly inpatients thought to be at risk for esophagealadenocarcinoma (Caucasians with reflux symptoms). It israrely seen in other groups with lower risk for thismalignancy (African-Americans, nonrefluxers). Conversely,SIM-GEJ and CLE without SIM are common in all groups andare of questionable significance.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1018863529777
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