PMID- 32941964
OWN - NLM
STAT- MEDLINE
DCOM- 20210329
LR  - 20210329
IS  - 1532-8392 (Electronic)
IS  - 0046-8177 (Linking)
VI  - 105
DP  - 2020 Nov
TI  - Intestinal metaplasia around the gastroesophageal junction is frequently 
      associated with antral reactive gastropathy: implications for carcinoma at the 
      gastroesophageal junction.
PG  - 67-73
LID - S0046-8177(20)30169-6 [pii]
LID - 10.1016/j.humpath.2020.08.007 [doi]
AB  - Increasing evidence suggests that bile reflux (BR) plays a major role in mucosal 
      injury, leading to adenocarcinoma of the proximal stomach and distal esophagus. 
      However, gastric BR is difficult to diagnose and investigate. Reactive 
      gastropathy (RG), in the absence of nonsteroidal anti-inflammatory drugs (NSAIDs) 
      and other known causes, likely represents bile-mediated injury to the gastric 
      mucosa. The goal of this study is to explore the association between antral RG 
      and gastroesophageal junction (GEJ) mucosal inflammation and intestinal 
      metaplasia (IM). The pathology database was searched for patients who had gastric 
      biopsies with a diagnosis of antral RG and concurrent gastric cardia/GEJ/distal 
      esophagus biopsies from 2013 to 2015. Age- and sex-matched patients with normal 
      gastric antral biopsies served as controls. Biopsies from the GEJ region were 
      evaluated for histological changes, including inflammation, antral and pancreatic 
      metaplasia, RG, the type of gastric glands, proton pump inhibitor (PPI) changes, 
      and IM. Detailed clinical history and medication use (including PPIs and NSAIDs) 
      were recorded. IM in the GEJ region was more frequent in patients with antral RG 
      than in controls (33.0% vs. 5.2%, 95% confidence interval [18.3-37.3%]). In 
      addition, inflammation, other mucosal changes around the GEJ (RG and foveolar 
      hyperplasia), antral IM, and PPI-associated mucosal changes were also more 
      frequently seen in patients with antral RG. Our results show that antral RG is 
      associated with mucosal injury and IM around GEJ, suggesting a role of BR. 
      Further studies are needed to study duodenogastric-esophageal BR and its role in 
      development of proximal gastric and distal esophageal adenocarcinoma.
CI  - Copyright (c) 2020. Published by Elsevier Inc.
FAU - Vyas, Monika
AU  - Vyas M
AD  - Department of Surgical Pathology, Yale University School of Medicine, New Haven, 
      CT, USA.
FAU - Celli, Romulo
AU  - Celli R
AD  - Department of Surgical Pathology, Yale University School of Medicine, New Haven, 
      CT, USA.
FAU - Singh, Manpreet
AU  - Singh M
AD  - Department of Internal Medicine (Section of Digestive Diseases), Yale University 
      School of Medicine, New Haven, CT, USA.
FAU - Patel, Natalie
AU  - Patel N
AD  - Department of Surgical Pathology, Yale University School of Medicine, New Haven, 
      CT, USA.
FAU - Aslanian, Harry R
AU  - Aslanian HR
AD  - Department of Internal Medicine (Section of Digestive Diseases), Yale University 
      School of Medicine, New Haven, CT, USA.
FAU - Boffa, Daniel
AU  - Boffa D
AD  - Surgery, Yale School of Medicine, New Haven, CT, USA.
FAU - Deng, Yanhong
AU  - Deng Y
AD  - Yale Center for Analytical Sciences, Yale University School of Public Health, New 
      Haven, CT, USA.
FAU - Ciarleglio, Maria M
AU  - Ciarleglio MM
AD  - Yale Center for Analytical Sciences, Yale University School of Public Health, New 
      Haven, CT, USA.
FAU - Laine, Loren
AU  - Laine L
AD  - Department of Internal Medicine (Section of Digestive Diseases), Yale University 
      School of Medicine, New Haven, CT, USA; Department of Internal Medicine (Section 
      of Digestive Diseases), VA-CT Healthcare System, West Haven, CT, USA.
FAU - Jain, Dhanpat
AU  - Jain D
AD  - Department of Surgical Pathology, Yale University School of Medicine, New Haven, 
      CT, USA. Electronic address: dhanpat.jain@yale.edu.
LA  - eng
PT  - Journal Article
DEP - 20200914
PL  - United States
TA  - Hum Pathol
JT  - Human pathology
JID - 9421547
SB  - IM
MH  - Adenocarcinoma/etiology/*pathology
MH  - Adult
MH  - Aged
MH  - Bile Reflux/complications
MH  - Biopsy
MH  - Databases, Factual
MH  - Esophageal Mucosa/pathology
MH  - Esophageal Neoplasms/etiology/*pathology
MH  - Esophagogastric Junction/*pathology
MH  - Female
MH  - Gastric Mucosa/*pathology
MH  - Humans
MH  - Male
MH  - Metaplasia
MH  - Middle Aged
MH  - Pyloric Antrum/*pathology
MH  - Retrospective Studies
MH  - Stomach Neoplasms/etiology/*pathology
OTO - NOTNLM
OT  - Barrett's esophagus
OT  - Bile reflux
OT  - Gastroesophageal junction
OT  - Intestinal metaplasia
OT  - Reactive gastropathy
EDAT- 2020/09/18 06:00
MHDA- 2021/03/30 06:00
CRDT- 2020/09/17 20:13
PHST- 2020/07/24 00:00 [received]
PHST- 2020/08/16 00:00 [revised]
PHST- 2020/08/26 00:00 [accepted]
PHST- 2020/09/18 06:00 [pubmed]
PHST- 2021/03/30 06:00 [medline]
PHST- 2020/09/17 20:13 [entrez]
AID - S0046-8177(20)30169-6 [pii]
AID - 10.1016/j.humpath.2020.08.007 [doi]
PST - ppublish
SO  - Hum Pathol. 2020 Nov;105:67-73. doi: 10.1016/j.humpath.2020.08.007. Epub 2020 Sep 
      14.