TY - JOUR
T1 - Intestinal and pancreatic metaplasia at the esophagogastric junction in patients without Barrett's esophagus
AU - Polkowski, Wojciech
AU - Van Lanschot, J. Jan B
AU - Ten Kate, Fiebo J W
AU - Rolf, Titia M.
AU - Polak, Mirjam
AU - Tytgat, Guido N J
AU - Obertop, Huug
AU - Offerhaus, G. Johan A
PY - 2000/3
Y1 - 2000/3
N2 - OBJECTIVES: A distinctive type of columnar epithelium with intestinal metaplasia is considered diagnostic for Barrett's esophagus. The neoplastic potential of pancreatic metaplasia at the esophagogastric junction is unknown. The aims of the present study were: 1) to characterize both forms of metaplasia at the esophagogastric junction, and to estimate their prevalence; 2) to investigate c-erbB-2 expression and K-ras mutations in pancreatic metaplasia; and 3) to study the relationship between metaplasia, inflammatory changes in the cardiac mucosa, and presence of H. pylori. METHODS: A total of 76 esophagogastrectomy specimens of patients with a normally located squamocolumnar junction, were investigated immunohistochemically. K-ras mutations were evaluated using PCR. RESULTS: Intestinal metaplasia in the cardia was found in 12% of patients: six complete-type, and three incomplete- type. Pancreatic metaplasia was demonstrated in 14% of patients, and neither c-erbB-2 expression nor K-ras mutations were found. Intestinal and pancreatic metaplasia were associated with mucosal inflammation. In contrast to generalized gastritis, isolated 'carditis' was not associated with H. pylori infection. CONCLUSIONS: When intestinal metaplasia occurs in a biopsy from the esophagogastric junction, it is not necessarily a marker for Barrett's esophagus. No indication was found that pancreatic metaplasia has neoplastic potential. Both forms of metaplasia reflect mucosal inflammation. Carditis may be a distinct inflammatory condition of the gastric mucosa that is not related to H. pylori infection. (C) 2000 by Am. Coll. of Gastroenterology.
AB - OBJECTIVES: A distinctive type of columnar epithelium with intestinal metaplasia is considered diagnostic for Barrett's esophagus. The neoplastic potential of pancreatic metaplasia at the esophagogastric junction is unknown. The aims of the present study were: 1) to characterize both forms of metaplasia at the esophagogastric junction, and to estimate their prevalence; 2) to investigate c-erbB-2 expression and K-ras mutations in pancreatic metaplasia; and 3) to study the relationship between metaplasia, inflammatory changes in the cardiac mucosa, and presence of H. pylori. METHODS: A total of 76 esophagogastrectomy specimens of patients with a normally located squamocolumnar junction, were investigated immunohistochemically. K-ras mutations were evaluated using PCR. RESULTS: Intestinal metaplasia in the cardia was found in 12% of patients: six complete-type, and three incomplete- type. Pancreatic metaplasia was demonstrated in 14% of patients, and neither c-erbB-2 expression nor K-ras mutations were found. Intestinal and pancreatic metaplasia were associated with mucosal inflammation. In contrast to generalized gastritis, isolated 'carditis' was not associated with H. pylori infection. CONCLUSIONS: When intestinal metaplasia occurs in a biopsy from the esophagogastric junction, it is not necessarily a marker for Barrett's esophagus. No indication was found that pancreatic metaplasia has neoplastic potential. Both forms of metaplasia reflect mucosal inflammation. Carditis may be a distinct inflammatory condition of the gastric mucosa that is not related to H. pylori infection. (C) 2000 by Am. Coll. of Gastroenterology.
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U2 - 10.1016/S0002-9270(99)00892-8
DO - 10.1016/S0002-9270(99)00892-8
M3 - Article
C2 - 10710048
AN - SCOPUS:0033995568
VL - 95
SP - 617
EP - 625
JO - American Journal of Gastroenterology
JF - American Journal of Gastroenterology
SN - 0002-9270
IS - 3
ER -