Prospective Study
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World J Gastroenterol. Dec 14, 2014; 20(46): 17588-17594
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17588
Prevalence, histologic and clinical characteristics of heterotopic gastric mucosa in Chinese patients
Yu Fang, Lei Chen, Dong-Feng Chen, Wan-Ying Ren, Cai-Fei Shen, Yin Xu, Yi-Ju Xia, Jing-Wen Li, Pu Wang, An-Ran Zhang, Shun-Zi Shao, Xiao-Na Yu, Gui-Yong Peng, Dian-Chun Fang
Yu Fang, Lei Chen, Cai-Fei Shen, Yin Xu, Yi-Ju Xia, Jing-Wen Li, Pu Wang, An-Ran Zhang, Shun-Zi Shao, Xiao-Na Yu, Gui-Yong Peng, Dian-Chun Fang, Department of Gastroenterology, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China
Yu Fang, Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
Dong-Feng Chen, Department of Gastroenterology, Daping Hospital, the Third Military Medical University, Chongqing 400042, China
Wan-Ying Ren, Department of Gastroenterology, Affiliated Hospital of Armed Police Medical College, Tianjin 300162, China
Author contributions: Fang Y, Chen L, Chen DF and Ren WY contributed equally to this work; Fang Y, Chen DF, Ren WY and Fang DC designed the research; Chen L, Peng GY, Ren WY, Fang DC, Chen DF performed endoscopies; Shen CF, Xu Y, Xia YJ, Li JW and Wang P analyzed the data; Zhang AR, Shao SZ, Yu XN, Fang DC, Peng GY and Ren WY interpreted the data; Fang Y and Fang DC wrote the manuscript.
Correspondence to: Dian-Chun Fang, PhD, MD, Professor, Department of Gastroenterology, Southwest Hospital, the Third Military Medical University, Gaotanyan, Shaping Str, Chongqing 400038, China. fangdianchun@hotmail.com
Telephone: +86-23-68754980 Fax: +86-23-68754980
Received: January 27, 2014
Revised: May 18, 2014
Accepted: July 15, 2014
Published online: December 14, 2014
Processing time: 324 Days and 19 Hours
Abstract

AIM: To determine the prevalence, demographic, clinical and histopathologic features of heterotopic gastric mucosa (HGM) in Chinese patients.

METHODS: Patients referred to three endoscopy units were enrolled in this study. The macroscopic characteristics of HGM were documented. Biopsies were obtained and observed using hematoxylin and eosin staining. Helicobacter pylori colonization was examined by Whartin-Starry staining.

RESULTS: HGM was observed in 420 Chinese patients, yielding a prevalence of 0.4%. The majority of patients had a single patch (300/420; 71.4%), while the remainder had two (84/420; 20%) or multiple patches (36/420; 8.6%). The size of the patches and the distance from the patch to the frontal incisor teeth varied significantly. The large majority of HGM patches were flat (393/420; 93.6%), whereas the remaining patches were slightly elevated. The primary histological characteristic was fundic-type (216/420; 51.4%) within the HGM patch, and antral- (43/420; 10.2%) and transitional-type (65/420; 15.5%) mucosa were also observed. The prevalence of intestinal metaplasia was 3.1% (13/420) and the prevalence of dysplasia was 1.4% (6/420), indicating the necessity for endoscopic follow-up in patients with HGM. Esophageal and extraesophageal complaints were also observed in patients with HGM. Dysphagia and epigastric discomfort (odds ratios: 6.836 and 115.826, respectively; Ps < 0.05) were independent risk factors for HGM.

CONCLUSION: Clinical complaints should be considered to improve the detection rate of HMG. The prevalence of intestinal metaplasia and dysplasia also indicates a need for endoscopic follow-up.

Keywords: Chinese population; Clinical characteristics; Heterotopic gastric mucosa; Histologic characteristics; Prevalence

Core tip: This study reports the prevalence, demographic, clinical and histologic features of heterotopic gastric mucosa (HGM) in Chinese patients. HGM was not commonly observed in the study population. Although malignant transformation was rare, intestinal metaplasia and dysplasia within HGM should be carefully followed-up. Some clinical symptoms, although not specific, were helpful in screening for HGM.