Alimentary TractSpecialized intestinal metaplasia, dysplasia, and cancer of the esophagus and esophagogastric junction: Prevalence and clinical data☆,☆☆,★,★★
Section snippets
Patients
The Walter Reed Army Medical Center (WRAMC) Gastroenterology Service is a tertiary referral center whose patient referral base comprises all Department of Defense beneficiaries, which include active-duty military and family members, public health service personnel, retirees, and all eligible Department of Defense designees. Study participants were selected from this population with the following exclusion criteria: (1) failure to give informed consent, (2) age less than 18 years, (3)
Patient characteristics
From January 1995 to September 1996, 1181 consecutive patients were referred for an endoscopic evaluation; 889 (75%) were eligible and consented to participate in the study (Figure 1). Fifty-six of these patients had suspected or known Barrett's esophagus and were not included in the prevalence calculations, but were included in the demographic data calculations. Of the 292 patients who did not participate in this study, 131 (45%) declined to participate and 161 (55%) were
Discussion
The clinical distinction between SIM of the esophagus and EGJ has not been well characterized. Investigators interested in the increasing incidence of adenocarcinoma of the esophagus postulate that Barrett's epithelium as defined by the presence of SIM in the esophagus is the precursor lesion to dysplasia and possible progression to cancer.18 In addition, the increase in the incidence of adenocarcinoma of the gastric cardia is thought to represent either the downward extension of, or possible
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Cited by (0)
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Address requests for reprints to: Roy K. H. Wong, M.D., Walter Reed Army Medical Center, 6900 Georgia Avenue Northwest, Building 2, Room 7F, Washington, D.C. 20307-5001.
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Supported by the Department of Clinical Investigation under Work Unit no. 1432.
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Dr. Hirota's current address is: Madigan Army Medical Center, Tacoma, Washington 98431; Dr. Loughney's current address is: Tripler Army Medical Center, Honolulu, Hawaii 96859.
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.