Document Detail


Pathophysiology of Barrett's esophagus.
MedLine Citation:
PMID:  9263345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A novel pathophysiology of Barrett's esophagus and a new method of assessing biopsy specimens in patients with gastroesophageal reflux disease (GERD) are presented. This is based on the observation in autopsy studies of patients without GERD that the squamous epithelium of the esophagus transitions directly to fundic mucosa in many people and that the cardiac mucosa is of very short length in others. Available evidence suggests that what is termed gastric cardiac mucosa is in reality an abnormal mucosa resulting from metaplasia of the squamous epithelium of the esophagus as a result of GERD. The severity of GERD correlates with the length of metaplastic cardiac mucosa and further changes occurring in it, permitting development of a system that provides good correlation between biopsy histology and severity of GERD. Intestinal metaplasia ("Barrett's esophagus") always occurs in this metaplastic cardiac mucosa. The recognition of this new pathophysiology of Barrett's esophagus permits identification of the entire sequence whereby GERD leads to adenocarcinoma: GERD-->cardiac metaplasia of squamous epithelium-->reflux carditis-->intestinal metaplasia-->dysplasia-->adenocarcinoma. This article also attempts to develop a terminology that avoids use of the confusing term "Barrett's esophagus," which should be discarded.
Authors:
P Chandrasoma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery     Volume:  9     ISSN:  1043-0679     ISO Abbreviation:  Semin. Thorac. Cardiovasc. Surg.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-10-07     Completed Date:  1997-10-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8917640     Medline TA:  Semin Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  270-8     Citation Subset:  IM    
Affiliation:
Department of Surgical Pathology, University of Southern California, Los Angeles 90033, USA.
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MeSH Terms
Descriptor/Qualifier:
Barrett Esophagus / etiology,  pathology,  physiopathology*
Cardia / pathology
Disease Progression
Esophagus / pathology
Gastric Mucosa / pathology
Gastroesophageal Reflux / complications,  pathology,  physiopathology
Humans
Metaplasia
Mucous Membrane / pathology
Stomach Diseases / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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