Examination of tissue distribution of Helicobacter pylori within columnar-lined esophagus

H. pylori may colonize columnar-lined esophagus, although an etiologic role in esophageal adenocarcinoma is unproven. H. pylori can adhere to intestin al metaplasia in the stomach. This study was designed to examine if H. pylo ri adheres to specialized intestinal metaplasia in columnar-lined esophagus . Esophageal biopsies from patients with columnar-lined esophagus were revi ewed. Patients with only gastric metaplasia were excluded. Sections with sp ecialized intestinal metaplasia in at least one third of at least one gland were recut, stained using the Giemsa stain, and reexamined by two independ ent pathologists using strict criteria for adherence by H. pylori. The 209 esophageal biopsies with adequate specialized intestinal metaplasia from 58 patients were examined: H. pylori was only seen on gastric metaplasia in t hree patients-and never on specialized intestinal metaplasia. Within the es ophagus, H. pylori adheres only to gastric metaplasia, which is not conside red premalignant for esophageal adenocarcinoma.