Nakamura M, Kawano T, Endo M, Iwai T
First Department of Surgery, Tokyo Medical and Dental University School of Medicine, Japan.
Am J Gastroenterol. 1999 Nov;94(11):3145-9. doi: 10.1111/j.1572-0241.1999.01506.x.
The significance of intestinal metaplasia found in biopsy specimens taken from healthy appearing squamocolumnar junction is unclear. The aim of the present study was to investigate the prevalence of intestinal metaplasia at the esophagogastric junction in Japanese patients with no clinical diagnosis of Barrett's esophagus.
A total of 103 specimens from consecutive surgeries were studied. All subjects underwent surgical resection for squamous carcinoma of the esophagus. Microscopic examination was performed from the squamocolumnar junction to 4 cm distal to the squamocolumnar junction. The extent of intestinal metaplasia was investigated in detail. Microscopic columnar-lined esophagus was defined as columnar epithelium with esophageal-type submucosal glands.
The extent of intestinal metaplasia varied and was usually identified at intervals. Intestinal metaplasia exactly at the squamocolumnar junction was identified in 29 of 103 specimens (28%). Microscopic columnar-lined esophagus was identified in five of the 103 (5%), four of which had intestinal metaplasia in the columnar-lined esophagus.
Intestinal metaplasia occurs frequently in the region of the esophagogastric junction in Japanese patients with squamous cell cancer of the esophagus.
取自外观正常的鳞柱状交界处活检标本中发现的肠化生的意义尚不清楚。本研究的目的是调查在无巴雷特食管临床诊断的日本患者中食管胃交界处肠化生的患病率。
对连续手术的103份标本进行研究。所有受试者均因食管鳞状细胞癌接受手术切除。从鳞柱状交界处至鳞柱状交界处远端4厘米处进行显微镜检查。详细调查肠化生的范围。显微镜下的柱状上皮食管定义为具有食管型黏膜下腺的柱状上皮。
肠化生的范围各不相同，通常呈间隔出现。103份标本中有29份（28%）在鳞柱状交界处确切发现肠化生。103份中有5份（5%）发现显微镜下的柱状上皮食管，其中4份在柱状上皮食管中有肠化生。
在患有食管鳞状细胞癌的日本患者中，食管胃交界处区域频繁发生肠化生。
