Cardiac mucosa at the gastro-oesophageal junction: indicator of gastro-oesophageal reflux disease? Data from a prospective central European multicentre study on histological and endoscopic diagnosis of oesophagitis (histoGERD trial).
AIMS
The origin and significance of cardiac mucosa at the gastro-oesophageal junction are controversial. In the prospective Central European multicentre histoGERD trial, we aimed to assess the prevalence of cardiac mucosa, characterized by the presence of glands composed of mucous cells without parietal cells, and to relate its presence to features related to gastro-oesophageal reflux disease (GORD).


METHODS AND RESULTS
One thousand and seventy-one individuals (576 females and 495 males; median age 53 years) were available for analysis. Overall, in biopsy specimens systematically taken from above and below the gastro-oesophageal junction, cardiac mucosa was observed in 713 (66.6%) individuals. Its presence was associated with patients' symptoms and/or complaints (P = 0.0025), histological changes of the squamous epithelium (P < 0.001) indicative of GORD, intestinal metaplasia (P < 0.001), and an endoscopic diagnosis of oesophagitis (P < 0.001). No association with an endoscopic diagnosis of Barrett's oesophagus or with gastric pathology, particularly Helicobacter infection, was observed.


CONCLUSIONS
Cardiac mucosa is a common finding in biopsy specimens taken from the gastro-oesophageal junction. Its association with reflux symptoms, histological changes indicating GORD and the endoscopic diagnosis of oesophagitis suggests that injury and repair related to GORD contribute to its development and/or expansion.
['Langner|Cord|C|', 'Schneider|Nora I|NI|', 'Plieschnegger|Wolfgang|W|', 'Schmack|Bertram|B|', 'Bordel|Hartmut|H|', 'Höfler|Bernd|B|', 'Eherer|Andreas J|AJ|', 'Wolf|Eva-Maria|EM|', 'Rehak|Peter|P|', 'Vieth|Michael|M|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002299:Cardia D002648:Child D004942:Esophagitis, Peptic D004943:Esophagogastric Junction D005260:Female D005753:Gastric Mucosa D005764:Gastroesophageal Reflux D006801:Humans D008297:Male D008875:Middle Aged D011446:Prospective Studies D055815:Young Adult
gastro-oesophageal junction reflux disease prevalence metaplasia gastric cardia