Prevalence, histologic and clinical characteristics of heterotopic gastric mucosa in Chinese patients

World J Gastroenterol. 2014 Dec 14;20(46):17588-94. doi: 10.3748/wjg.v20.i46.17588.

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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People*
  • Biopsy
  • Chi-Square Distribution
  • China / epidemiology
  • Choristoma / ethnology*
  • Choristoma / microbiology
  • Choristoma / pathology
  • Esophageal Diseases / ethnology*
  • Esophageal Diseases / microbiology
  • Esophageal Diseases / pathology
  • Esophagoscopy
  • Female
  • Gastric Mucosa*
  • Helicobacter Infections / ethnology
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / isolation & purification
  • Humans
  • Logistic Models
  • Male
  • Metaplasia
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Young Adult