Intestinal metaplasia in Barrett's oesophagus: An essential factor to predict the risk of dysplasia and cancer development

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• 作者：Marianna Salemme^a ; Vincenzo Villanacci^a ; Gianpaolo Cengia^b ; Renzo Cestari^b ; Guido Missale^b ; Gabrio Bassotti^c ; ^{gabassot@tin.it" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Barrett's oesophagus ; Cancer development ; Endoscopy ; Intestinal metaplasia
• 刊名：Digestive and Liver Disease
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：48
• 期：2
• 页码：144-147
• 全文大小：1626 K

文摘

To date, there is still uncertainty on the role of specialized intestinal metaplasia in the carcinogenic process of Barrett's oesophagus (BE); this fact seems of importance for planning adequate surveillance programs.

Aims

To predict the risk of progression towards dysplasia/cancer based on typical morphological features by evaluating the importance of intestinal metaplasia in BE patients.

Methods

647 cases with a histological diagnosis of BE, referred to the Endoscopy Unit of a tertiary centre between 2000 and 2012 were retrospectively identified, and divided into two groups according to the presence/absence of intestinal metaplasia. For each patient, all histological reports performed during a follow-up of 4–8 years were analyzed.

Results

Overall, 537 cases (83%) with intestinal metaplasia and 110 cases (17%) without intestinal metaplasia were included. During the follow-up period, none of the patients without intestinal metaplasia developed dysplasia/cancer nor progressed to metaplasia, whereas 72 patients with intestinal metaplasia (13.4%) showed histological progression of the disease.

Conclusion

The histological identification of intestinal metaplasia seems to be an essential factor for the progression towards dysplasia and cancer in BE patients.