Department of Pathology, Shizuoka City Shimizu Hospital, Miyakami 1231, Shimizu-Ku, Shizuoka 424-8636, Japan.
Pathol Res Pract. 2011 Mar 15;207(3):148-50. doi: 10.1016/j.prp.2010.12.004. Epub 2011 Jan 16.
The author retrieved and retrospectively investigated biopsy specimens of heterotopic gastric mucosa registered in our computer database. There were 1008 cases affecting the esophagus, 684 cases affecting the duodenum, and 1636 cases affecting the colorectum. A total of 158 cases of heterotopic gastric mucosa were identified (84 cases affecting the esophagus, 74 cases affecting the duodenum, and no case affecting the colorectum). The frequency amounted to 8% in the esophagus, 11% in the duodenum, and 0% in the colorectum. The male to female ratio was 112:46, and the mean age was 62.22±14.29 years. Pathologically, two types of heterotopic gastric mucosa were identified. The first type consisted of gastric glands and foveolar epithelium, and the second type was composed only of foveolar epithelium. The first type was recognized in 69 of 84 cases (82%) in the esophagus, and in 54 of 74 cases (73%) in the duodenum. The second type was encountered in 15 of 84 cases (18%) in the esophagus, and in 20 of 74 cases (27%) in the duodenum. The first type appeared to be of congenital origin, while the second type was reminiscent of foveolar metaplasia. Foveolar hyperplasia and mild lymphocytic infiltration were frequent in the heterotopic gastric mucosa. Goblet cell metaplasia was recognized in 11 cases. The most frequent clinical diagnosis of heterotopic gastric mucosa of the esophagus was heterotopic gastric mucosa, followed in order by iodine-unstained area, reflux disease, flat elevation, polyp, carcinoma, ulcer, erosion, redness, submucosal tumor, esophagitis, adenoma, and tumor. The most frequent clinical diagnosis of heterotopic gastric mucosa in the duodenum was polyp, followed in order by ulcer, tumor, submucosal tumor, carcinoma, and duodenitis. The data suggest that esophageal gastric mucosa and duodenal heterotopic gastric mucosa are common lesions, with a frequency of about 9% in biopsy specimens in Japan.
作者检索并回顾性调查了登记在我们计算机数据库中的异位胃黏膜活检标本。其中食管受累 1008 例，十二指肠受累 684 例，直肠结肠受累 1636 例。共发现 158 例异位胃黏膜（食管 84 例，十二指肠 74 例，直肠结肠无）。频率在食管为 8%，在十二指肠为 11%，在直肠结肠为 0%。男女性别比为 112:46，平均年龄为 62.22±14.29 岁。病理上，发现两种类型的异位胃黏膜。第一种类型由胃腺和小凹上皮组成，第二种类型仅由小凹上皮组成。第一种类型在食管的 84 例中占 69 例（82%），在十二指肠的 74 例中占 54 例（73%）。第二种类型在食管的 84 例中占 15 例（18%），在十二指肠的 74 例中占 20 例（27%）。第一种类型似乎是先天性的，而第二种类型类似于小凹上皮化生。异位胃黏膜中常见小凹上皮增生和轻度淋巴细胞浸润。在 11 例中发现杯状细胞化生。食管异位胃黏膜最常见的临床诊断是异位胃黏膜，其次是碘不染区、反流病、扁平隆起、息肉、癌、溃疡、糜烂、发红、黏膜下肿瘤、食管炎、腺瘤和肿瘤。十二指肠异位胃黏膜最常见的临床诊断是息肉，其次是溃疡、肿瘤、黏膜下肿瘤、癌和十二指肠炎。这些数据表明，食管胃黏膜和十二指肠异位胃黏膜是常见病变，在日本活检标本中的发生率约为 9%。
