Prevalence and clinical features of heterotopic gastric mucosa in the upper oesophagus (inlet patch)

Maconi, Giovanni; Pace, F.; Vago, Luca; Carsana, Luca; Bargiggia, S.; Porro, G. Bianchi

doi:10.1097/00042737-200012070-00005

Cited by 94 publications

(97 citation statements)

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“…It presents as either a single or multiple patches localized just below the upper esophageal sphincter. Microscopically, the patch can be lined with fundic or gastric body type glands (1)(2)(3). The prevalence of EGM ranges www.bjournal.com.br from 0.1 to 4.9% in most series, reaching 10% in a prospective study (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

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Over-expression of cyclooxygenase-2 in endoscopic biopsies of ectopic gastric mucosa

Martins

Neto

Oshima

et al. 2007

Braz J Med Biol Res

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Ectopic gastric mucosa (EGM) is considered to be a congenital condition. Rare cases of adenocarcinoma have been described. There are no data justifying regular biopsies or follow-up. Cyclooxygenase-2 (COX-2) is a protein involved in gastrointestinal tumor development by inhibiting apoptosis and regulating angiogenesis. The aim of this prospective study was to evaluate COX-2 expression in EGM and compare it with normal tissue and Barrett's esophagus. We evaluated 1327 patients. Biopsies were taken from the inlet patch for histological evaluation and from the gastric antrum to assess Helicobacter pylori infection. Biopsies taken from normal esophageal, gastric antrum and body mucosa and Barrett's esophagus were retrieved from a tissue bank. EGM biopsies were evaluated with respect to type of epithelium, presence of H. pylori, and inflammation. COX-2 was detected by immunohistochemistry using the avidin-biotin complex. EGM islets were found in 14 patients (1.1%). Histological examination revealed fundic type epithelium in 58.3% of cases, H. pylori was present in 50% and chronic inflammation in 66.7%. Expression of COX-2 was negative in normal distal esophagus, normal gastric antrum and normal gastric body specimens (10 each). In contrast, EGM presented over-expression of COX-2 in 41.7% of cases and Barrett's esophagus in 90% of cases (P = 0.04 and 0.03, respectively). COX-2 immunoexpression in EGM was not related to gender, age, epithelium type, presence of inflammation or intestinal metaplasia, H. pylori infection, or any endoscopic finding. Our results demonstrate up-regulation of COX-2 in EGM, suggesting a possible malignant potential of this so-called harmless mucosa.

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Section: Introductionmentioning

confidence: 99%

“…Microscopically, the patch can be lined with fundic or gastric body type glands (1)(2)(3). The prevalence of EGM ranges www.bjournal.com.br from 0.1 to 4.9% in most series, reaching 10% in a prospective study (1)(2)(3). The presence of Helicobacter pylori has been reported in 20 to 56.5% of cases (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Over-expression of cyclooxygenase-2 in endoscopic biopsies of ectopic gastric mucosa

Martins

Neto

Oshima

et al. 2007

Braz J Med Biol Res

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show abstract

“…In contrast, MUC5AC positivity was noted on the surface, pits and the glands of Barrett's esophagus. The HGMP/CIP can also be colonized by Helicobacter pylori and the patches are subjected to changes that are seen in the stomach (Akbayir et al, 2004;Alagozlu et al, 2010;BorhanManesh & Franum, 1991Gutierrez et al, 2003;Jacobs et al, 1997;Maconi et al, 2000;Poyrazoglu et al, 2009;Tang et al, 2004;Yüksel et al, 2008). Chronic inflammatory changes can be seen and progression to atrophy, intestinal metaplasia, dysplasia and malignant transformation have been reported (Borhan-Manesh & Franum, 1991).…”

Section: Histologymentioning

confidence: 99%

“…For a small proportion of patients, the symptoms can be prominent and patients may have many consultations before a diagnosis is made. The prevalence of any symptoms, typically those considered extra-esophageal symptoms complex of gastroesophageal reflux such as chronic cough, throat irritation or sore throat, regurgitation, globus pharyngeus, dysphagia or hoarseness ranges from very low to as high as 75% (Chong & Jalihal, 2010;Maconi et al, 2000). HGMP/CIP like other ectopic gastric mucosal have been proven to be able to secrete acid in sufficient quantity to induce inflammatory changes and acid related symptoms (Baudet et al, 2006;Galan et al, 1998;Hamilton et al, 1986;Korkut et al, 2010;Nakalima et al, 1993;Yüksel et al, 2008).…”

Section: Clinical Manifestationsmentioning

confidence: 99%

“…In future studies, it is very important that the endoscopists are aware and to look for this lesions. Several studies have already reported that the pick up rates were higher when endoscopist were aware of the entity (Maconi et al, 2000;Azar et al, 2007). The third controversy relates the clinical significance of HGMP/CIP in clinical practice.…”

Section: Controversiesmentioning

confidence: 99%

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