Endoscopic diagnosis of cervical esophageal heterotopic gastric mucosa with conventional and narrow-band images

• Published in: World journal of gastroenterology : WJG Vol. 20; no. 1; pp. 242 - 249
• Main Author: Cheng, Chi-Liang
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 07.01.2014
• Subjects: Adult; Aged; Brief; Cervical; Choristoma - complications; Choristoma - pathology; Deglutition Disorders - etiology; Endo; Esophageal Diseases - complications; Esophageal Diseases - pathology; Esophagoscopy - methods; esophagus; Female; gastric; Gastric Mucosa; Heterotopic; Humans; Male; Metaplasia; Middle Aged; mucosa; Narrow Band Imaging; Pharyngitis - etiology; Predictive Value of Tests; Prospective Studies; Heterotopic gastric mucosa; Narrow-band imaging; Endoscopic diagnosis; Conventional imaging; Cervical esophagus
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v20.i1.242

AIM:To compare the diagnostic yield of heterotopic gastric mucosa(HGM)in the cervical esophagus with conventional imaging(CI)and narrow-band imaging(NBI).METHODS:A prospective study with a total of 760patients receiving a CI examination(mean age 51.6years;47.8%male)and 760 patients undergoing NBI examination(mean age 51.2 years;45.9%male).The size of HGM was classified as small(1-5 mm),medium(6-10 mm),or large(>1 cm).A standardized questionnaire was used to obtain demographic characteristics,social habits,and symptoms likely to be related to cervical esophageal HGM,including throat symptoms(globus sensation,hoarseness,sore throat,and cough)and upper esophageal symptoms(dysphagia and odynophagia)at least 3 mo in duration.The clinicopathological classification of cervical esophageal HGM was performed using the proposal by von Rahden et al.RESULTS:Cervical esophageal HGM was found in 36of 760(4.7%)and 63 of 760(8.3%)patients in the CI and NBI groups,respectively(P=0.007).The NBI mode discovered significantly more small-sized HGM than CI(55%vs 17%;P<0.0001).For the 99 patients with cervical esophageal HGM,biopsies were performed in 56 patients;37(66%)had fundic-type gastric mucosa,and 19 had antral-type mucosa.For the clinicopathological classification,77 patients(78%)were classified as HGMⅠ(asymptomatic carriers);21 as HGMⅡ(symptomatic without morphologic changes);and one as HGMⅢ(symptomatic with morphologic change).No intraepithelial neoplasia or adenocarcinoma was found.CONCLUSION:NBI endoscopy detects more cervical esophageal HGM than CI does.Fundic-type gastric mucosa constitutes the most common histology.One-fifth of patients have throat or dysphagic symptoms.