The Intestinal metaplasia at esophagogastric junction: Frequency, types and causes

6. ABSTRACT Background: The incidence of adenocarcinoma of the esophagogastric junction (EJ) has been increasing more than two decades. As intestinal metaplasia (IM) is associated with the development of esophageal and gastric cancer, the same reason can be responsible from development of EJ cancers. Even tough numerous studies evaluating IM at EJ has been performed, the etiology of I M at E J is still unclear. The present observations suggest that either gastroesophageal reflux disease (GERD) or Helicobacter pylori (Hp) infection may play a role for the etiopathogenesis of IM at EJ. Aims: To determine prevalence, etiologic factors and types of IM at the esophagus and EJ in an area with high Hp prevalence. Methods: A total of 100 patients (51 F, 49M, 55.3±13.5) who underwent upper gastrointestinal endoscopy were randomly enrolled in the study. During the endoscopy procedure esophageal mucosa stained with lugol. The biopsies from the esophageal mucosa not stained by lugol, Z line, cardia (below the 5 mm of Z line), corpus and antrum were taken. Gastritis, Hp and the presence of I M have been examined pathologically in those samples. The types of IM were determined by high iron diamin stain. Results: IM at the Z line and cardia were found 30% and 38% and the inflammation at Z line and cardia were detected 81% and 89%, respectively. Inflammation at the Z line and cardia were associated with both Hp infection and corpus/antrum gastritis. The frequency of short segment Barrett's esophagus was found to be 7%. The types of IM at Z line and gastric mucosa are shown in table below. Table. The frequency of I M types in different regions. Conclusion: IM and inflammation at the Z line and cardia are highly frequent in our study. These are associated with Hp infection but not GERD. Type I IM at cardia and Type II IM in esophagus were found to be more frequent. 51