INTESTINAL METAPLASIA AT THE SQUAMOCOLUMNAR JUNCTION IN PATIENTS ATTENDING FOR DIAGNOSTIC GASTROSCOPY

Background-The incidence of adenocarcinoma of the oesophagus and gastr ic cardia is increasing rapidly. Barrett's oesophagus is the major ris k factor. Intestinal metaplasia at the squamocolumnar junction in the absence of Barrett's oesophagus is common but its relation to adenocar cinoma and gastro-oesophageal reflux disease is unclear. Aims-To study the prevalence and clinical, endoscopic, and histological association s of intestinal metaplasia at the squamocolumnar junction. Methods-Bio psy specimens were taken from 120 randomly selected patients undergoin g routine diagnostic endoscopy. Eight biopsy specimens, taken from abo ve and below the squamocolumnar junction, gastric fundus, and gastric antrum, were stained with haematoxylin/eosin, alcian blue/periodic aci d-Schiff, and Gimenez, and graded independently by one pathologist. Re sults-Intestinal metaplasia at the squamocolumnar junction was found i n 21 patients (18%). Metaplasia was associated with increasing age (p< 0.01) and antral intestinal metaplasia (p=0.04). Logistic regression a nalysis revealed that age was the only independent predictor (p<0.01). There was no association with symptomatic, endoscopic, or histologica l markers of gastro-oesophageal reflux disease. Conclusions-Intestinal metaplasia at the squamocolumnar junction is a common finding. It is associated with increasing age but not gastro-oesophageal reflux disea se.