Endoscopic and histological study on shortª²segment Barrett¡¯s esophagus and cardia intestinal metaplasia

    CHANG Ying, GONG Jun, LIU Bin, ZHANG Jun, DAI Fei, WAN Xiaoª²Long, WANG Tao

    1Department of Gastroenterology, Second Hospital, Xi¡¯an Jiaotong University, Xi¡¯an 710004, China, 2Department of Emergence Surgery, Shaanxi Provincial People¡¯s Hospital, Xi¡¯an 710068, China

    ¡¾Abstract¡¿ AIM: To investigate the endoscopic and histological characteristics of shortª²segment Barrett¡¯s esophagus (SSBE) and cardia intestinal metaplasia ( CIM) and their associations with Helicobacter pylori gastritis and gastroª²esophageal reflux disease (GERD). METHODS: Eight biopsy specimens taken from lower esophagus, cardia and gastric antrum in 32 cases of SSBE and 41 cases of CIM were stained with haematoxylin/eosin (HE), alcian blue/periodic acidª²Schiff (ABª²PAS), alcian blue/high iron diamine (ABª²HID) and Gimenez, respectively. RESULTS: It was found that the SSBE patients were younger than the CIM patients (P<0.01). The incidence of dysplasia and incomplete intestinal metaplasia in SSBE patients was higher than that in the CIM patients(P<0.01, P<0.01). Compared with the CIM patients, the incidence of reflux symptomatic, endoscopic, or histological markers of GERD was higher in SSBE patients (P<0.01), whereas the incidence of H.pylori infection and antral intestinal metaplasia was lower in SSBE patients (P<0.05, P<0.01). CONCLUSION: The dysplasia risk is significantly higher in SSBE patients than in CIM patients, indicating two potentially different clinical processes of the two diseases. CIM is a manifestation of H. pylori infection associated with gastritis and multifocal atrophic gastritis, while SSBE may result from GERD. ......