Yüksel Ilhami, Usküdar Oğuz, Köklü Seyfettin, Başar Omer, Gültuna Selcan, Unverdi Selman, Oztürk Zeynel A, Sengül Demet, Arikök Ata Türker, Yüksel Osman, Coban Sahin
Department of Gastroenterology, Ankara Dişkapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
Scand J Gastroenterol. 2008 Aug;43(8):910-4. doi: 10.1080/00365520801986619.
Ectopic gastric tissue in the esophagus (inlet patch) mostly presents in the upper part of the esophagus and is usually under-diagnosed because of its localization. Little is known about its pathogenesis and significance. The aim of this study was to investigate whether there is an association between ectopic gastric tissue development and endoscopic features of the upper gastrointestinal tract, especially in the esophagus.
A total of 9437 endoscopic examinations were analyzed prospectively. Endoscopic features and histological examinations of inlet patch and stomach specimens were documented. Endoscopic findings in patients with inlet patch were compared with those in patients without inlet patch.
Inlet patch was present in 171 (1.8%) of all patients. Forty-three (25.1%) patients with inlet patch and 519 (5.6%) patients without inlet patch had esophagitis (p = 0.000). Histologically proven Barrett's esophagus was more frequent among patients with inlet patch than among patients without inlet patch (3.5% versus 0.5%, p = 0.000). Prevalences of hiatal hernia in the two groups were similar. Open cardia was diagnosed more frequently in the inlet patch group than in the other group (24.5% versus 10.0%, p = 0.000). Helicobacter pylori colonization was detected in only 11% of inlet patch specimens, whereas 58% of stomach specimens from the same patients contained H. pylori colonies.
Patients with inlet patch seem to have predisposing factors for gastroesophageal reflux, and Barrett's esophagus is found more frequently in those patients. H. pylori colonization is involved in ectopic gastric tissue less frequently than in gastric tissue.
食管内异位胃组织（入口斑）多位于食管上部，因其位置关系常被漏诊。对其发病机制及意义知之甚少。本研究旨在探讨异位胃组织的发生与上消化道内镜特征之间是否存在关联，尤其是在食管方面。
前瞻性分析了9437例内镜检查病例。记录入口斑和胃标本的内镜特征及组织学检查结果。将有入口斑患者的内镜检查结果与无入口斑患者的进行比较。
所有患者中171例（1.8%）存在入口斑。有入口斑的患者中有43例（25.1%）发生食管炎，无入口斑的患者中有519例（5.6%）发生食管炎（p = 0.000）。经组织学证实的巴雷特食管在有入口斑的患者中比无入口斑的患者更常见（3.5%对0.5%，p = 0.000）。两组食管裂孔疝的患病率相似。入口斑组诊断出开放型贲门的频率高于另一组（24.5%对10.0%，p = 0.000）。仅11%的入口斑标本检测到幽门螺杆菌定植，而同一患者的胃标本中有58%含有幽门螺杆菌菌落。
有入口斑的患者似乎有胃食管反流的易感因素，且这些患者中巴雷特食管更常见。幽门螺杆菌定植被发现参与异位胃组织形成的频率低于胃组织。
