Objectives: The gastric mucosal change accompanying gastric antral intestinal metaplasia (IM) in the pediatric population and its clinical implications remain unclear. Methods: We retrieved all patients younger than 18 years who had upper GI endoscopy with a pathology diagnosis of antral IM between 2009 and 2020. Each biopsy was evaluated for the presence of dysplasia, Helicobacter pylori, gastritis, and other pathologic changes. Results: A total of 134 patients with antral IM were identified; 72 (53.7%) with coexisting pathology including chronic gastritis (n = 22), reactive gastropathy (n = 16), focal mild chronic inflammation (n = 13), gastric eosinophilia (n = 9), chronic active gastritis associated with (n = 2) and without Helicobacter infection (n = 3), and others (n = 7). The remaining 62 (46.3%) showed isolated IM. Gastric IM increased with age, and was often accompanied by other pathologic changes, especially in female children. Twenty-seven patients had follow up biopsies; 11 of the 27 patients (40.7%) showed persistent IM in at least one repeat biopsies. None demonstrated dysplasia. Conclusions: In children, antral IM increases with age and often coexists with other pathologic changes. Gastric IM could persist for at least months to years in a significant subset of patients with chronic gastritis and gastric eosinophilia.

中文翻译：

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肠化生儿童胃窦粘膜变化。

目的：儿童人群中伴随胃窦肠上皮化生（IM）的胃黏膜变化及其临床意义仍不清楚。方法：我们检索了所有在 2009 年至 2020 年期间接受过上消化道内镜检查且病理诊断为胃窦 IM 的 18 岁以下患者。评估每次活检是否存在发育异常、幽门螺杆菌、胃炎和其他病理变化。结果：共识别出 134 例胃窦 IM 患者；72 例 (53.7%) 合并病理包括慢性胃炎 (n = 22)、反应性胃病 (n = 16)、局灶性轻度慢性炎症 (n = 13)、胃嗜酸性粒细胞增多症 (n = 9)、慢性活动性胃炎相关 (n = 2) 和没有幽门螺杆菌感染 (n = 3) 和其他 (n = 7)。其余 62 (46.3%) 显示孤立的 IM。胃 IM 随年龄增长而增加，并常伴有其他病理变化，尤其是在女童中。27 名患者进行了随访活检；27 名患者中有 11 名（40.7%）在至少一次重复活检中表现出持续性 IM。没有人表现出发育异常。结论：在儿童中，胃窦 IM 随年龄增长而增加，并且经常与其他病理变化并存。在相当一部分患有慢性胃炎和胃嗜酸性粒细胞增多症的患者中，胃 IM 可以持续至少数月至数年。胃窦 IM 随年龄增长而增加，并常与其他病理变化并存。在相当一部分患有慢性胃炎和胃嗜酸性粒细胞增多症的患者中，胃 IM 可以持续至少数月至数年。胃窦 IM 随年龄增长而增加，并常与其他病理变化并存。在相当一部分患有慢性胃炎和胃嗜酸性粒细胞增多症的患者中，胃 IM 可以持续至少数月至数年。