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Korean J Helicobacter  Up Gastrointest Res > Volume 12(3); 2012 > Article
The Korean Journal of Helicobacter  and Upper Gastrointestinal Research 2012;12(3):171-177.
DOI: https://doi.org/10.7704/kjhugr.2012.12.3.171    Published online September 10, 2012.
The Clinical Significance of Specialized Intestinal Metaplasia in the Diagnosis of Barrett's Esophagus: Nationwide Prospective Multicenter Study
Hyun Kyung Park, Nayoung Kim, Byoung Hwan Lee, Jin Il Kim, So Young Lee, Hyun Min Cha, Hyerang Kim, Soo Hyun Park, Jong Jae Park, Sang Woo Lee, Ki Nam Shim, Seong Eun Kim, Su Jin Hong, Il Kwun Chung, Gwang Ho Baik, Hyun Soo Kim, Sungkook Kim, Jae Kyu Seong, Geom Seog Seo, Sam Ryong Jee, Jeong Seop Moon, Mee Yon Cho, Jae Woo Kim, Moon Gi Chung, Seon Mee Park, Byung Kyu Nah, Su Youn Nam, Kang Seok Seo, Byung Sung Ko, Yun Ju Jo, Jae Young Jang, Byeong Gwan Kim, Ji Won Kim, Kyung Sik Park, Hyun Shin Park, Young Sun Kim, Seon Hee Lim, Chung Hyeon Kim, Min Jung Park, Jeong Yoon Yim, Kyung Ran Cho, Donghee Kim, Seun Ja Park, Geun Am Song, Hyun Jin Kim, Sang Wook Kim, Eui Hyeog Im, Kyoung Soo Lee, Dong Hyo Hyun, Hyun Young Kim, Sun Mi Kim, Jeong Eun Shin, Chan Guk Park, Chang Hun Yang, Soo Heon Park, Hyun Chae Jung, In Sik Chung
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. nayoungkim49@empal.com
2Department of Internal Medicine, Catholic University of Korea, College of Medicine, Seoul, Korea.
3Health Promotion Center, Seoul St. Mary's Hospital, Seoul, Korea.
4Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
5Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
6Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.
7Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea.
8Department of Internal Medicine, Chonnam National University School of Medicine, Gwangju, Korea.
9Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
10Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
11Department of Internal Medicine, Digestive Disease Research Institute, Wonkang University College of Medicine, Iksan, Korea.
12Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
13Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, Korea.
14Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
15Department of Internal Medicine, Gachon Medical School, Incheon, Korea.
16Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
17Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea.
18Korean National Cancer Center, Ilsan, Korea.
19Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea.
20Department of Internal Medicine, Eulji University College of Medicine, Daejeon, Korea.
21Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
22Department of Internal Medicine, Seoul National University Boramae Hospital, Seoul, Korea.
23Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea.
24Health Promotion Center, Inha University College of Medicine, Incheon, Korea.
25Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.
26Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea.
27Department of Internal Medicine, Busan National University College of Medicine, Busan, Korea.
28Department of Internal Medicine, Kyungsang National University College of Medicine, Jinju, Korea.
29Department of Internal Medicine, Chonbuk National University School of Medicine, Jeonju, Korea.
30Department of Internal Medicine, Kunyang University College of Medicine, Daejeon, Korea.
31Cheju Halla General Hospital, Jeju, Korea.
32Hanmaeum Hospital, Jeju, Korea.
33Health Promotion Center, Seoul National University Bundang Hospital, Seongnam, Korea.
34Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
35Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea.
36Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea.
37Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
바렛식도 진단에 있어서 특수 장상피화생의 임상적 의의: 전국적 다기관 연구
박현경1, 김나영1, 이병환1, 김진일2, 이소영2, 차현민2, 김혜랑3, 박소현3, 박종재4, 이상우4, 심기남5, 김성은5, 홍수진6, 정일권6, 백광호7, 김현수8, 김성국9, 성재규10, 서검석11, 지삼룡12, 문정섭12, 조미연13, 김재우14, 정문기15, 박선미16, 나병규17, 남수연18, 서강석19, 고병성20, 조윤주20, 장재영21, 김병관22, 김지원22, 박경식23, 박현신24, 김영선25, 임선희25, 김충현25, 박민정25, 임정윤25, 조경란25, 김동희25, 박선자26, 송근암27, 김현진28, 김상욱29, 임의혁30, 이경수31, 현동효32, 김현영33, 김선미33, 신정은34, 박찬국35, 양창헌36, 박수헌2, 정현채37, 정인식2, 대한상부위장관 · 헬리코박터 학회
분당서울대학교병원 내과1, 가톨릭대학교 의과대학 내과학교실2, 서울성모병원 건강증진센터3, 고려대학교 의과대학 내과학교실4, 이화여자대학교 의학전문대학원 내과학교실5, 순천향대학교 의과대학 내과학교실6, 한림대학교 의과대학 내과학교실7, 전남대학교 의과대학 내과학교실8, 경북대학교 의학전문대학원 내과학교실9, 충남대학교 의학전문대학원 내과학교실10, 원광대학교 의과대학 내과학교실 원광 소화기질환 연구소11, 인제대학교 의과대학 내과학교실12, 연세대학교 원주의과대학 병리학교실13, 연세대학교 원주의과대학 내과학교실14, 가천의대 인천길병원 내과15, 충북대학교 의과대학 내과학교실16, 강릉아산병원 내과17, 국립암센터 암예방검진센터18, 광주기독병원 내과19, 을지대학교 의과대학 내과학교실20, 경희대학교 의과대학 내과학교실21, 보라매병원 내과22, 계명대학교 의과대학 내과학교실23, 인하대학교병원 건강증진센터24, 서울대학교병원 강남센터25, 고신대학교 의과대학 내과학교실26, 부산대학교 의과대학 내과학교실27, 경상대학교 의과대학 내과학교실28, 전북대학교 의과대학 내과학교실29, 건양대학교 의과대학 내과학교실30, 제주한라병원31, 한마음병원32, 분당서울대학교병원 건강증진센터33, 단국대학교병원 내과학교실34, 조선대학교 의과대학 내과학교실35, 동국대학교 의과대학 내과학교실36, 서울대학교 의과대학 내과학교실37
Abstract
BACKGROUND/AIMS
The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Key Words: Barrett esophagus; Metaplasia; Gastroesophageal reflux
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