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Intentional examination of esophagus by narrow-band imaging endoscopy increases detection rate of cervical inlet patch.
Dis Esophagus. 2015 Oct; 28(7):666-72.DE

Abstract

Foci of heterotopic gastric mucosa have been identified at different sites in the human body and the most common location is the proximal esophagus which is referred to as cervical inlet patch (CIP). The true prevalence of CIP varies and it is usually incidental findings during endoscopy. Because CIP is always asymptomatic, it was believed to be of little clinical relevance. However, emerging studies have described the acid-secreting characteristics of heterotopic gastric mucosa and associations of CIP with gastroesophageal reflux disease (GERD). In addition, complications such as stricture, fistula, infection, mucosal hyperplasia, and malignant transformation have been reported. In this study, we investigated the prevalence of CIP, its associations with clinical manifestations, and the effect of intentional screening upper esophagus by magnifying endoscopy-narrow-band imaging (ME-NBI) system. Consecutive healthy adults who underwent panendoscopy were separated into two groups. Patients in group I (n = 471) were examined by an endoscopist who intended to find CIPs by ME-NBI. Patients in group II (n = 428) were examined by two endoscopists who were unaware of the study and performed white-light imaging endoscopy. Participants provided questionnaires on GERD-related symptoms. Higher CIP prevalence (11.7% vs. 1.9%, P < 0.0001) and longer duration of esophageal examination (mean ± standard deviation, 17.50 ± 12.40 vs. 15.24 ± 10.78 seconds, P = 0.004) were noted in group I than in group II. Analyzing group I patients revealed the higher prevalences of reflux symptoms (32.7% vs. 18.3%, P = 0.013) and erosive esophagitis (43.6% vs. 25.5%, P = 0.005) in patients with CIP than in those without. CIP was not associated with globus or dysphagia symptoms. More small CIPs (< 5 mm) were detected by ME-NBI than by white-light imaging (85.3% vs. 41.4%, P = 0.001). In conclusion, CIP prevalence was not low under intentional ME-NBI examination of the upper esophagus. The clinical relevance of CIP and its association with GERD require further investigation.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25059461

Citation

Chung, C-S, et al. "Intentional Examination of Esophagus By Narrow-band Imaging Endoscopy Increases Detection Rate of Cervical Inlet Patch." Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, vol. 28, no. 7, 2015, pp. 666-72.
Chung CS, Lin CK, Liang CC, et al. Intentional examination of esophagus by narrow-band imaging endoscopy increases detection rate of cervical inlet patch. Dis Esophagus. 2015;28(7):666-72.
Chung, C. S., Lin, C. K., Liang, C. C., Hsu, W. F., & Lee, T. H. (2015). Intentional examination of esophagus by narrow-band imaging endoscopy increases detection rate of cervical inlet patch. Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, 28(7), 666-72. https://doi.org/10.1111/dote.12252
Chung CS, et al. Intentional Examination of Esophagus By Narrow-band Imaging Endoscopy Increases Detection Rate of Cervical Inlet Patch. Dis Esophagus. 2015;28(7):666-72. PubMed PMID: 25059461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intentional examination of esophagus by narrow-band imaging endoscopy increases detection rate of cervical inlet patch. AU - Chung,C-S, AU - Lin,C-K, AU - Liang,C-C, AU - Hsu,W-F, AU - Lee,T-H, Y1 - 2014/07/24/ PY - 2014/7/26/entrez PY - 2014/7/26/pubmed PY - 2016/7/23/medline KW - cervical inlet patch KW - gastroesophageal reflux disease KW - heterotopic gastric mucosa KW - narrow-band imaging SP - 666 EP - 72 JF - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus JO - Dis. Esophagus VL - 28 IS - 7 N2 - Foci of heterotopic gastric mucosa have been identified at different sites in the human body and the most common location is the proximal esophagus which is referred to as cervical inlet patch (CIP). The true prevalence of CIP varies and it is usually incidental findings during endoscopy. Because CIP is always asymptomatic, it was believed to be of little clinical relevance. However, emerging studies have described the acid-secreting characteristics of heterotopic gastric mucosa and associations of CIP with gastroesophageal reflux disease (GERD). In addition, complications such as stricture, fistula, infection, mucosal hyperplasia, and malignant transformation have been reported. In this study, we investigated the prevalence of CIP, its associations with clinical manifestations, and the effect of intentional screening upper esophagus by magnifying endoscopy-narrow-band imaging (ME-NBI) system. Consecutive healthy adults who underwent panendoscopy were separated into two groups. Patients in group I (n = 471) were examined by an endoscopist who intended to find CIPs by ME-NBI. Patients in group II (n = 428) were examined by two endoscopists who were unaware of the study and performed white-light imaging endoscopy. Participants provided questionnaires on GERD-related symptoms. Higher CIP prevalence (11.7% vs. 1.9%, P < 0.0001) and longer duration of esophageal examination (mean ± standard deviation, 17.50 ± 12.40 vs. 15.24 ± 10.78 seconds, P = 0.004) were noted in group I than in group II. Analyzing group I patients revealed the higher prevalences of reflux symptoms (32.7% vs. 18.3%, P = 0.013) and erosive esophagitis (43.6% vs. 25.5%, P = 0.005) in patients with CIP than in those without. CIP was not associated with globus or dysphagia symptoms. More small CIPs (< 5 mm) were detected by ME-NBI than by white-light imaging (85.3% vs. 41.4%, P = 0.001). In conclusion, CIP prevalence was not low under intentional ME-NBI examination of the upper esophagus. The clinical relevance of CIP and its association with GERD require further investigation. SN - 1442-2050 UR - https://www.unboundmedicine.com/medline/citation/25059461/Intentional_examination_of_esophagus_by_narrow_band_imaging_endoscopy_increases_detection_rate_of_cervical_inlet_patch_ L2 - https://academic.oup.com/dote/article-lookup/doi/10.1111/dote.12252 DB - PRIME DP - Unbound Medicine ER -