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AN ENDOSCOPIC AND MAGNIFYING ENDOSCOPIC STUDY OF ESOPHAGEAL CARDIAC GLAND: WHAT ROLE DOES ESOPHAGEAL CARDIAC GLAND PLAY AT THE ESOPHAGO‐GASTRIC JUNCTION?
Author(s) -
Yagi Kazuyoshi,
Aruga Yukio,
Nakamura Atsuo,
Sekine Atsuo
Publication year - 2005
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2005.00514.x
Subject(s) - medicine , gerd , esophagus , carditis , gastroenterology , biopsy , esophagitis , antrum , reflux esophagitis , endoscopy , lesion , stomach , pathology , reflux , disease
The purpose of this study was to ascertain whether areas of yellow elevated change in the distal squamous epithelium represent esophageal cardiac gland and to further assess the features of the exposed esophageal cardiac gland in the magnified view. In addition, the relationship between the columnar‐lined esophagus, gastro‐esophageal reflux disease (GERD), reflux esophagitis, and H. pylori infection was also assessed. Fifty patients (28 men, 22 women; median age 61 years) underwent elective upper GI endoscopy. The distal margin of the squamo‐columnar junction was observed to ascertain whether a yellow elevated lesion was present. When such a lesion was observed, this area was studied using magnifying endoscopy with acetic acid and a biopsy specimen was taken. Furthermore, biopsy specimens of the cardia, antrum, and body were taken for biopsy specimen to check for the presence of carditis, gastritis, and H. pylori . Of 38 patients showing the yellow elevated change, all showed exposed columnar epithelium and 30 patients proved to have esophageal cardiac gland tissue in biopsy specimens. Of 31 patients with H. pylori infection, all had carditis and the yellow elevated lesion. Of 19 patients with a H. pylori ‐negative normal stomach, none had carditis and seven patients had the yellow elevated change which was ascertained to be esophageal cardia by biopsy. The yellow elevated change at the distal squamo‐columnar junction was revealed to be esophageal cardiac gland and exposed esophageal cardiac gland was visible in all cases by magnifying endoscopy with acetic acid.