Endoscopic and histological study on short-segment Barrett’s esophagus and cardia intestinal metaplasia

AIM: To investigate the endoscopic and histological characteristics of short segment Barrett’s esophagus (SSBE) and cardia intestinal metaplasia ( CIM) and their associations with Helicobacter pylori gastritis and gastro esophageal reflux disease (GERD). METHODS: Eight biopsy specimens taken from lower esophagus, cardia and gastric antrum in 32 cases of SSBE and 41 cases of CIM were stained with haematoxylin/eosin (HE), alcian blue/periodic acid Schiff (AB PAS), alcian blue/high iron diamine (AB HID) and Gimenez, respectively. RESULTS: It was found that the SSBE patients were younger than the CIM patients ( P 0.01). The incidence of dysplasia and incomplete intestinal metaplasia in SSBE patients was higher than that in the CIM patients( P 0.01, P 0.01). Compared with the CIM patients, the incidence of reflux symptomatic, endoscopic, or histological markers of GERD was higher in SSBE patients ( P 0.01), whereas the incidence of H.pylori infection and antral intestinal metaplasia was lower in SSBE patients ( P 0.05, P 0.01). CONCLUSION: The dysplasia risk is significantly higher in SSBE patients than in CIM patients, indicating two potentially different clinical processes of the two diseases. CIM is a manifestation of H. pylori infection associated with gastritis and multifocal atrophic gastritis, while SSBE may result from GERD.