PROSPECTIVE EVALUATION OF INTESTINAL METAPLASIA AND DYSPLASIA WITHIN THE CARDIA OF PATIENTS WITH BARRETTS-ESOPHAGUS

The prevalence of cardia versus noncardia gastric intestinal metaplasi a in patients with Barrett's esophagus was assessed prospectively. Fou r-quadrant biopsies were obtained from the cardia from 119 consecutive patients with Barrett's esophagus and 64 control patients. Gastric su rveillance biopsies were obtained in 108 of the Barrett's patients and 58 control patients, There was a significantly greater prevalence of cardia intestinal metaplasia in short-segment Barrett's (10.2%), but n ot traditional Barrett's (3.3%), compared to control patients (0%) (P = 0.009), Dysplastic changes were significantly more frequent in the m etaplastic epithelium within the esophagus than in the cardia (P < 0.0 001), A significantly greater prevalence of noncardia intestinal metap lasia compared to cardia intestinal metaplasia was found in each of th e three groups of patients; however, the prevalence of noncardia intes tinal metaplasia between short-segment, traditional, and control patie nts was not significantly different. Cardia intestinal metaplasia was an infrequent finding in patients with Barrett's esophagus and appears to develop independently from that in the remainder of the stomach.