Specialized intestinal metaplasia of the esophagogastric junction may imply an increased cancer risk. In the light of rising incidence rates of adenocarcinomas of the cardia and distal esophagus, there is, however, still uncertainty whether patients should be screened for intestinal metaplasia and if found selected for cancer surveillance. To investigate the natural course of intestinal metaplasia at the esophagogastric junction 235 patients were reinvestigated after a median follow-up period of 31 months. As controls served patients with either histologically proven Barrett`s esophagus, or patients with only endoscopic Barrett`s esophagus, i.e. endoscopic signs of Barrett`s esophagus but no intestinal metaplasia at histology. The course of intestinal metaplasia at the esophagogastric junction, of the endoscopic Barrett`s esophagus and the histologically proven Barrett`s esophagus is regarding both endoscopy and histology rather heterogeneous. An interobserver variability was shown between pathologists in distinguishing columnar epithelium in Barrett`s esophagus that stains positive on alcian blue from intestinal metaplasia with goblet cells. Further investigations are necessary to show whether the discrepancies between previous examinations and follow-up examinations concerning the proof of intestinal metaplasia of the esophagogastric junction are caused by inaccurate endoscopic evaluation or actual inconstant course of the findings. There is no indication for an increased risk for dysplasia.
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Specialized intestinal metaplasia of the esophagogastric junction may imply an increased cancer risk. In the light of rising incidence rates of adenocarcinomas of the cardia and distal esophagus, there is, however, still uncertainty whether patients should be screened for intestinal metaplasia and if found selected for cancer surveillance. To investigate the natural course of intestinal metaplasia at the esophagogastric junction 235 patients were reinvestigated after a median follow-up perio...
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