Long-term follow-up of intestinal metaplasia of the gastric cardia

Thomas G. Morales, Elizabeth Camargo, Achyut K Bhattacharyya, Richard E. Sampliner

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVE: Recent studies have found a relatively high prevalence of gastric cardia intestinal metaplasia in individuals presenting for elective upper endoscopy. It has been hypothesized that this lesion may be a precursor of gastric cardia cancer. Our objective was to identify the incidence of dysplasia in patients with gastric cardia intestinal metaplasia. METHODS: Twenty-eight patients who had previously been identified with cardia intestinal metaplasia had follow-up examinations performed. None of the patients had dysplasia at the time of diagnosis. All had an examination at 1 yr, and 20 patients had an examination at 3 yr after diagnosis. During follow-up examinations all patients underwent vital staining with methylene blue to help identify areas of intestinal metaplasia in the cardia. Two to four biopsies were taken from blue-stained mucosa. Histological specimens were stained using a combination of hematoxylin and eosin with Alcian blue at pH 2.5. RESULTS: There were 27 men and one woman with a mean age of 69.8 yr (range, 48-83 yr). The mean length of follow-up was 2.5 yr (range, 12-46 months). Only one patient was diagnosed with dysplasia (low-grade) during the study, for an incidence of 1.4% per yr. CONCLUSIONS: The prevalence (0%) and incidence (1.4%/yr) of dysplasia in cardia intestinal metaplasia are low. Although further studies are needed, screening and surveillance for gastric cardia intestinal metaplasia is unlikely to be clinically useful for the prevention of gastric cardia cancer. (C) 2000 by Am. Coll. of Gastroenterology.

Original languageEnglish (US)
Pages (from-to)1677-1680
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume95
Issue number7
DOIs
StatePublished - Jul 2000

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Cardia
Metaplasia
Stomach
Stomach Neoplasms
Alcian Blue
Methylene Blue
Incidence
Gastroenterology
Hematoxylin
Eosine Yellowish-(YS)
Endoscopy
Mucous Membrane
Cohort Studies
Staining and Labeling
Biopsy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Long-term follow-up of intestinal metaplasia of the gastric cardia. / Morales, Thomas G.; Camargo, Elizabeth; Bhattacharyya, Achyut K; Sampliner, Richard E.

In: American Journal of Gastroenterology, Vol. 95, No. 7, 07.2000, p. 1677-1680.

Research output: Contribution to journalArticle

Morales, Thomas G. ; Camargo, Elizabeth ; Bhattacharyya, Achyut K ; Sampliner, Richard E. / Long-term follow-up of intestinal metaplasia of the gastric cardia. In: American Journal of Gastroenterology. 2000 ; Vol. 95, No. 7. pp. 1677-1680.
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abstract = "OBJECTIVE: Recent studies have found a relatively high prevalence of gastric cardia intestinal metaplasia in individuals presenting for elective upper endoscopy. It has been hypothesized that this lesion may be a precursor of gastric cardia cancer. Our objective was to identify the incidence of dysplasia in patients with gastric cardia intestinal metaplasia. METHODS: Twenty-eight patients who had previously been identified with cardia intestinal metaplasia had follow-up examinations performed. None of the patients had dysplasia at the time of diagnosis. All had an examination at 1 yr, and 20 patients had an examination at 3 yr after diagnosis. During follow-up examinations all patients underwent vital staining with methylene blue to help identify areas of intestinal metaplasia in the cardia. Two to four biopsies were taken from blue-stained mucosa. Histological specimens were stained using a combination of hematoxylin and eosin with Alcian blue at pH 2.5. RESULTS: There were 27 men and one woman with a mean age of 69.8 yr (range, 48-83 yr). The mean length of follow-up was 2.5 yr (range, 12-46 months). Only one patient was diagnosed with dysplasia (low-grade) during the study, for an incidence of 1.4{\%} per yr. CONCLUSIONS: The prevalence (0{\%}) and incidence (1.4{\%}/yr) of dysplasia in cardia intestinal metaplasia are low. Although further studies are needed, screening and surveillance for gastric cardia intestinal metaplasia is unlikely to be clinically useful for the prevention of gastric cardia cancer. (C) 2000 by Am. Coll. of Gastroenterology.",
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