The length of columnar-lined esophagus and the frequency of intestinal metaplasia

R. F. Saidi, W. K. Fackler, S. L. Kim, J. G. Hunter, John Wo, L. P. Davis, J. P. Waring

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

PURPOSE: The evolving definition of Barrett's esophagus (BE) requires the histologic finding of intestinal metaplasia rather than the endoscopic length of columnar-lined esophagus. We sought to determine the correlation between the probability of biopsying intestinal metaplasia (IM) in patients with endoscopic evidence of columnar-lined esophagus (CLE). METHODS: We reviewed our endoscopy and histology data from 1992 to 1997. In consecutive patients undergoing EGD for any indication, 4 quadrant biopsies were taken just below the squamocolumnar junction and every two centimeters within any CLE. The extent of CLE above the gastric folds and the worst pathologic diagnosis were recorded. Patients undergoing Barrett's surveillance were counted only once (longest CLE and worst pathology recorded). RESULTS: 349 patients (mean age 62, 45% female) had complete data. Twenty-four percent had strictures and 22% had evidence of esophagitis at the EGD recorded. The length and pathology correlation was as follows: Length (cm) n %IM dysplasia 1 83 26.5 0 2 65 23.1 1.5 3 68 36.8 2.9 4 28 53.6 7.1 5 18 61.1 0 6 13 69.2 20 >6 24 83.3 21 When patients with and without IM were compared, there was no statistically significant difference in frequency of strictures, esophagitis, age, sex. CONCLUSIONS: The frequency of intestinal metaplasia and dysplasia correlates with increasing length of endoscopic columnar-lined esophagus. Endoscopic features which may cause symptoms are not associated with either IM or extent of CLE. Any columnar epithelium in the tubular esophagus should be biopsied, regardless of other endoscopic findings. In CLE of > 5 cm, dysplasia is present in over 20% and biopsies should be taken for diagnosis of dysplasia.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume47
Issue number4
StatePublished - 1998
Externally publishedYes

Fingerprint

Metaplasia
Esophagus
Esophagitis
Pathologic Constriction
Pathology
Biopsy
Barrett Esophagus
Endoscopy
Stomach
Histology
Epithelium

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Saidi, R. F., Fackler, W. K., Kim, S. L., Hunter, J. G., Wo, J., Davis, L. P., & Waring, J. P. (1998). The length of columnar-lined esophagus and the frequency of intestinal metaplasia. Gastrointestinal Endoscopy, 47(4).

The length of columnar-lined esophagus and the frequency of intestinal metaplasia. / Saidi, R. F.; Fackler, W. K.; Kim, S. L.; Hunter, J. G.; Wo, John; Davis, L. P.; Waring, J. P.

In: Gastrointestinal Endoscopy, Vol. 47, No. 4, 1998.

Research output: Contribution to journalArticle

Saidi, RF, Fackler, WK, Kim, SL, Hunter, JG, Wo, J, Davis, LP & Waring, JP 1998, 'The length of columnar-lined esophagus and the frequency of intestinal metaplasia', Gastrointestinal Endoscopy, vol. 47, no. 4.
Saidi, R. F. ; Fackler, W. K. ; Kim, S. L. ; Hunter, J. G. ; Wo, John ; Davis, L. P. ; Waring, J. P. / The length of columnar-lined esophagus and the frequency of intestinal metaplasia. In: Gastrointestinal Endoscopy. 1998 ; Vol. 47, No. 4.
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N2 - PURPOSE: The evolving definition of Barrett's esophagus (BE) requires the histologic finding of intestinal metaplasia rather than the endoscopic length of columnar-lined esophagus. We sought to determine the correlation between the probability of biopsying intestinal metaplasia (IM) in patients with endoscopic evidence of columnar-lined esophagus (CLE). METHODS: We reviewed our endoscopy and histology data from 1992 to 1997. In consecutive patients undergoing EGD for any indication, 4 quadrant biopsies were taken just below the squamocolumnar junction and every two centimeters within any CLE. The extent of CLE above the gastric folds and the worst pathologic diagnosis were recorded. Patients undergoing Barrett's surveillance were counted only once (longest CLE and worst pathology recorded). RESULTS: 349 patients (mean age 62, 45% female) had complete data. Twenty-four percent had strictures and 22% had evidence of esophagitis at the EGD recorded. The length and pathology correlation was as follows: Length (cm) n %IM dysplasia 1 83 26.5 0 2 65 23.1 1.5 3 68 36.8 2.9 4 28 53.6 7.1 5 18 61.1 0 6 13 69.2 20 >6 24 83.3 21 When patients with and without IM were compared, there was no statistically significant difference in frequency of strictures, esophagitis, age, sex. CONCLUSIONS: The frequency of intestinal metaplasia and dysplasia correlates with increasing length of endoscopic columnar-lined esophagus. Endoscopic features which may cause symptoms are not associated with either IM or extent of CLE. Any columnar epithelium in the tubular esophagus should be biopsied, regardless of other endoscopic findings. In CLE of > 5 cm, dysplasia is present in over 20% and biopsies should be taken for diagnosis of dysplasia.

AB - PURPOSE: The evolving definition of Barrett's esophagus (BE) requires the histologic finding of intestinal metaplasia rather than the endoscopic length of columnar-lined esophagus. We sought to determine the correlation between the probability of biopsying intestinal metaplasia (IM) in patients with endoscopic evidence of columnar-lined esophagus (CLE). METHODS: We reviewed our endoscopy and histology data from 1992 to 1997. In consecutive patients undergoing EGD for any indication, 4 quadrant biopsies were taken just below the squamocolumnar junction and every two centimeters within any CLE. The extent of CLE above the gastric folds and the worst pathologic diagnosis were recorded. Patients undergoing Barrett's surveillance were counted only once (longest CLE and worst pathology recorded). RESULTS: 349 patients (mean age 62, 45% female) had complete data. Twenty-four percent had strictures and 22% had evidence of esophagitis at the EGD recorded. The length and pathology correlation was as follows: Length (cm) n %IM dysplasia 1 83 26.5 0 2 65 23.1 1.5 3 68 36.8 2.9 4 28 53.6 7.1 5 18 61.1 0 6 13 69.2 20 >6 24 83.3 21 When patients with and without IM were compared, there was no statistically significant difference in frequency of strictures, esophagitis, age, sex. CONCLUSIONS: The frequency of intestinal metaplasia and dysplasia correlates with increasing length of endoscopic columnar-lined esophagus. Endoscopic features which may cause symptoms are not associated with either IM or extent of CLE. Any columnar epithelium in the tubular esophagus should be biopsied, regardless of other endoscopic findings. In CLE of > 5 cm, dysplasia is present in over 20% and biopsies should be taken for diagnosis of dysplasia.

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