Tags

Type your tag names separated by a space and hit enter

The gastric cardia in gastro-oesophageal disease.
J Clin Pathol 2000; 53(8):619-25JC

Abstract

BACKGROUND

There have been conflicting reports concerning the use of cardia biopsies in screening patients for gastro-oesophageal disease.

AIM

To define the histopathological changes in the gastric cardia of patients with and without gastro-oesophageal disease.

METHODS

Topographically mapped gastric biopsy specimens were obtained from patients with gastro-oesophageal disease and from controls. Biopsies were scored on a visual analogue scale of 0 to 5 for Helicobacter pylori, intestinal metaplasia, pancreatic metaplasia, foveolar hyperplasia, and active inflammation. The presence or absence of cardiac glands was recorded.

RESULTS

Sixty-five patients with gastro-oesophageal disease and 71 controls were examined. Intestinal metaplasia was present in cardia biopsies of 10 patients with gastro-oesophageal disease and 11 controls. Only two patients with gastro-oesophageal disease and intestinal metaplasia in the cardia had no evidence of exposure to H pylori. Intestinal metaplasia was not found in the cardia of those with long segment Barrett's oesophagus. Carditis was strongly associated with active H pylori infection (p = 0.000) and resolved after treatment of the infection. A negative association was present between gastro-oesophageal disease and the presence of cardiac glands in cardiac biopsies (p = 0.003). Pancreatic metaplasia was found in 15 of 65 and foveolar hyperplasia in 19 of 65 cases but neither was related to gastro-oesophageal disease.

CONCLUSION

Intestinal metaplasia in the cardia is uncommon in gastro-oesophageal disease in the absence of H pylori infection. With chronic H pylori infection the junction between the cardia and corpus expands in a cardia-corpal direction.

Authors+Show Affiliations

Gastrointestinal Mucosa Pathology Laboratory, Veterans Affairs Medical Center, Houston, Texas 77030, USA. hzimaity@bcm.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11002767

Citation

el-Zimaity, H M., et al. "The Gastric Cardia in Gastro-oesophageal Disease." Journal of Clinical Pathology, vol. 53, no. 8, 2000, pp. 619-25.
el-Zimaity HM, Verghese VJ, Ramchatesingh J, et al. The gastric cardia in gastro-oesophageal disease. J Clin Pathol. 2000;53(8):619-25.
el-Zimaity, H. M., Verghese, V. J., Ramchatesingh, J., & Graham, D. Y. (2000). The gastric cardia in gastro-oesophageal disease. Journal of Clinical Pathology, 53(8), pp. 619-25.
el-Zimaity HM, et al. The Gastric Cardia in Gastro-oesophageal Disease. J Clin Pathol. 2000;53(8):619-25. PubMed PMID: 11002767.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The gastric cardia in gastro-oesophageal disease. AU - el-Zimaity,H M, AU - Verghese,V J, AU - Ramchatesingh,J, AU - Graham,D Y, PY - 2000/9/26/pubmed PY - 2000/9/30/medline PY - 2000/9/26/entrez SP - 619 EP - 25 JF - Journal of clinical pathology JO - J. Clin. Pathol. VL - 53 IS - 8 N2 - BACKGROUND: There have been conflicting reports concerning the use of cardia biopsies in screening patients for gastro-oesophageal disease. AIM: To define the histopathological changes in the gastric cardia of patients with and without gastro-oesophageal disease. METHODS: Topographically mapped gastric biopsy specimens were obtained from patients with gastro-oesophageal disease and from controls. Biopsies were scored on a visual analogue scale of 0 to 5 for Helicobacter pylori, intestinal metaplasia, pancreatic metaplasia, foveolar hyperplasia, and active inflammation. The presence or absence of cardiac glands was recorded. RESULTS: Sixty-five patients with gastro-oesophageal disease and 71 controls were examined. Intestinal metaplasia was present in cardia biopsies of 10 patients with gastro-oesophageal disease and 11 controls. Only two patients with gastro-oesophageal disease and intestinal metaplasia in the cardia had no evidence of exposure to H pylori. Intestinal metaplasia was not found in the cardia of those with long segment Barrett's oesophagus. Carditis was strongly associated with active H pylori infection (p = 0.000) and resolved after treatment of the infection. A negative association was present between gastro-oesophageal disease and the presence of cardiac glands in cardiac biopsies (p = 0.003). Pancreatic metaplasia was found in 15 of 65 and foveolar hyperplasia in 19 of 65 cases but neither was related to gastro-oesophageal disease. CONCLUSION: Intestinal metaplasia in the cardia is uncommon in gastro-oesophageal disease in the absence of H pylori infection. With chronic H pylori infection the junction between the cardia and corpus expands in a cardia-corpal direction. SN - 0021-9746 UR - https://www.unboundmedicine.com/medline/citation/11002767/The_gastric_cardia_in_gastro_oesophageal_disease_ L2 - http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=11002767 DB - PRIME DP - Unbound Medicine ER -