World Journal of
Pharmaceutical and Life Sciences

LONG TERM FOLLOW-UP OF NON-GOBLET CELL AND GOBLET CELL COLUMNAR LINED LOWER END ESOPHAGUS

Poonam Bhaker and Dr. Kim Vaiphei*

ABSTRACT

Background: Significance of non goblet (GC) columnar mucosa (CM) present at lower end esophagus (LEE) remains controversial, and there is limited information of the follow-up data. Aim: to evaluate outcome of Barrett's mucosa (BM) and NGCM in long term follow-up biopsies. Methods: retrospectively evaluated biopsies reported as columnar mucosa (CM) with and without GC and correlated with clinical outcome. Results: There were 178 patients, mean age of 52.1±15.6, 7 <20 years, M:F=5:1; 70% had reflux symptom and 30% had dysphagia. Endoscopy: only BM in 130(73%), ulceronodular in 17%, stricture in 5% and small polyps in 5%. Sixty (34%) cases had long segment (LSBM) and 70(54%) short segment (SSBM); 11% had hiatus hernia. Histology: GCs were identified in 83% of the biopsies, 94% with LSBM. Dysplasia was observed in 65 (37%), low grade (LGD) in 68% and high grade (HGD) in 32%, 26( 14%) had carcinoma associated with BM and HGD. Thirty (17%) biopsies with no GC showed alcian blue (AB) positive cells, 7(4%) had LGD and 3(2%) had HGD, none had associated carcinoma. Follow-up biopsy showed regression and normalization of mucosa and symptomatic relieve in many. Majority of LGD remained static with few progressing to HGD. Majority of HGD progressed to frank carcinoma over the years. Conclusion: high percentage of non-GCCM showed AB positivity and dysplasia. Many of cases with BM, LGD and HGD developed carcinoma. Ulceronodular and stricturous lesions associate frequently with BM and carcinoma. Present study emphasizes equal importance of follow-up biopsy in BM and NGCM.

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