McClave S A, Boyce H W, Gottfried M R
Department of Medicine, University of Louisville School of Medicine, Kentucky 40292.
Gastrointest Endosc. 1987 Dec;33(6):413-6. doi: 10.1016/s0016-5107(87)71676-9.
The relationship between the proximal margins of the gastric mucosal folds and the squamocolumnar mucosal junction (SCMJ) in normal subjects and in patients with columnar-lined esophagus (CLE) was studied. Results indicate that in the normal esophagus, the SCMJ is located within 2 cm of the proximal margin of the gastric folds. The proximal margin of the gastric folds in a hiatal hernia pouch provide a fixed, reproducible, anatomic landmark at endoscopy, which designates the junction of the muscular wall of the esophagus and stomach and permits one to predict the expected normal location of the SCMJ. The diagnosis of CLE should be considered at endoscopy when either the SCMJ is located or columnar epithelium is obtained by biopsy at a site greater than 2 cm above the proximal margin of the gastric folds located within a hiatal hernia pouch. This study provides an endoscopic criterion to permit a more accurate diagnosis of CLE in its earliest stages and may permit a better assessment of its prevalence.
研究了正常受试者和柱状上皮内衬食管（CLE）患者胃黏膜皱襞近端边缘与鳞状柱状黏膜交界处（SCMJ）之间的关系。结果表明，在正常食管中，SCMJ位于胃皱襞近端边缘的2厘米范围内。食管裂孔疝囊内胃皱襞的近端边缘在内镜检查时提供了一个固定的、可重复的解剖标志，它确定了食管和胃肌壁的交界处，并使人们能够预测SCMJ的预期正常位置。当SCMJ位于食管裂孔疝囊内胃皱襞近端边缘上方2厘米以上的部位，或通过活检在此部位获得柱状上皮时，内镜检查应考虑CLE的诊断。本研究提供了一种内镜标准，以便在CLE的最早阶段进行更准确的诊断，并可能更好地评估其患病率。
