Dinçer Dinc, Besisik Fatih, Sahin Edibe, Demir Kadir, Tuncer Ilyas, Cevikbas Ugur, Mungan Zeynel, Kaymakoglu Sabahattin, Boztas Güngör, Ozdil Sadakat, Cakaloglu Yilmaz, Okten Atilla
Department of Gastroenterohepatology, Istanbul Medical Faculty, Istanbul, Turkey.
Hepatogastroenterology. 2002 Jul-Aug;49(46):1153-6.
BACKGROUND/AIMS: We aimed to investigate the prevalence of intestinal metaplasia in the cardia of a patient group with high incidence of Helicobacter pylori infection presenting for elective upper endoscopy. We also re-evaluated the relation between intestinal metaplasia in the cardia and gastroesophageal reflux disease, smoking, alcohol history, H. pylori infection, Barrett's esophagus and intestinal metaplasia elsewhere in the stomach.
Sixty patients presenting for elective upper endoscopy were included in this study. Prior to undergoing endoscopy each patient was questioned with regard to the clinical indication and symptoms including heartburn, regurgitation, and dysphagia. In addition, a smoking and alcohol history were recorded. Endoscopic biopsies: 1) one from the midantrum on the lesser curvature, 2) one from the incisura angularis, 3) one from the mid-corpus on the lesser curvature, 4) one from the columnar side of the squamocolumnar junction, 5) one from the squamous side of the squamocolumnar junction, 6) one from 2 cm distal to the esophagogastric junction, 7) one from across the squamocolumnar junction. Slides were stained using a combination of hematoxylin-eosin with Alcian blue at pH 2.5 for intestinal metaplasia. Each specimen was examined for the presence of H. pylori.
The prevalence of H. pylori infection was 63%. Prevalence of the H. pylori infection was significantly lower in the patients with intestinal metaplasia of the cardia than in the patients without intestinal metaplasia of the cardia (P = 0.025). There was a positive correlation between the age of the patients and having intestinal metaplasia of the cardia (r = 0.286, P = 0.008). There was no relationship between intestinal metaplasia of the cardia and pyrozis, regurgitation, dysphagia, history of alcohol and smoking esophagitis determined by endoscopy or histopathology, sex, intestinal metaplasia elsewhere in the stomach (P > 0.05).
The incidence of the intestinal metaplasia of the gastric cardia in Turkey is less than that of western countries. Intestinal metaplasia of the gastric cardia negatively correlates with H. pylori infection. And there was no relationship between gastric cardia intestinal metaplasia and reflux disease. Further investigations are needed for determining the premalign lesion and etiologic factors for cancer of the gastric cardia.
背景/目的：我们旨在调查一组因择期上消化道内镜检查前来就诊、幽门螺杆菌感染发生率较高的患者贲门部肠化生的患病率。我们还重新评估了贲门部肠化生与胃食管反流病、吸烟、饮酒史、幽门螺杆菌感染、巴雷特食管以及胃其他部位肠化生之间的关系。
本研究纳入了60例因择期上消化道内镜检查前来就诊的患者。在接受内镜检查前，对每位患者询问了临床指征和症状，包括烧心、反流和吞咽困难。此外，记录了吸烟和饮酒史。内镜活检：1）取自胃小弯中部胃窦；2）取自角切迹；3）取自胃小弯中部胃体；4）取自鳞柱状交界处的柱状侧；5）取自鳞柱状交界处的鳞状侧；6）取自食管胃交界处远端2 cm处；7）取自跨越鳞柱状交界处。玻片采用苏木精-伊红与pH 2.5的阿尔辛蓝联合染色以检测肠化生。对每个标本检测幽门螺杆菌的存在情况。
幽门螺杆菌感染率为63%。贲门部有肠化生的患者中幽门螺杆菌感染率显著低于贲门部无肠化生的患者（P = 0.025）。患者年龄与贲门部肠化生之间存在正相关（r = 0.286，P = 0.008）。贲门部肠化生与内镜或组织病理学确定的烧心、反流、吞咽困难、饮酒和吸烟史、食管炎、性别、胃其他部位肠化生之间均无关系（P > 0.05）。
土耳其胃贲门部肠化生的发生率低于西方国家。胃贲门部肠化生与幽门螺杆菌感染呈负相关。胃贲门部肠化生与反流病之间无关系。需要进一步研究以确定胃贲门癌的癌前病变和病因。
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