BACKGROUND & AIMS Endoscopic eradication therapy (EET) for Barrett's esophagus (BE) has unclear effects on the gastric cardia. We investigated the prevalence of intestinal metaplasia (IM) and dysplasia in the cardia after complete eradication of IM (CEIM) and the incidence of newly diagnosed cardia IM or dysplasia after EET. METHODS We performed a prospective study, from 2013 through 2016, of patients with previously successful EET undergoing surveillance after CEIM (cross-sectional group) and treatment-naïve patients with BE undergoing EET (longitudinal group). Standard biopsies were collected from multiple levels in the cardia and analyzed histologically. We calculated the prevalence (cross-sectional group) and the incidence (longitudinal group) of cardia IM or dysplasia after EET. RESULTS Of the 116 patients in the cross-sectional group, 17 (15%) had cardia IM or dysplasia after CEIM: 12 patients had IM, 2 patients were indefinite for dysplasia, and 3 patients had low-grade dysplasia. Cardia IM or dysplasia were most commonly found at the tops of gastric folds. Among 42 subjects in the longitudinal group, the pre-treatment prevalence of cardia IM or dysplasia was 28.5% (3 with non-dysplastic IM, 9 with dysplastic IM, 1 indefinite for dysplasia, 2 with low-grade dysplasia, 3 with high-grade dysplasia, and 3 with intramucosal cancer). All achieved CEIM. The incidence of cardia IM or dysplasia was 11.9% after 18 months of follow up. IM or dysplasia was more higher in the cardia after CEIM than in the tubular esophagus (P < .01). CONCLUSIONS In a prospective study, we found that cardia dysplasia becomes less, not more, common, after successful EET; recurrence of IM or dysplasia was more frequent in the cardia than the esophagus. Patients with BE undergoing EET should have careful examination of the cardia, with a single set of surveillance biopsies at the top of the gastric folds.

中文翻译：

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内镜治疗后Barrett食管患者肠Card上皮化生和胃Card门发育异常的发生率和发生率。

背景与目的内镜根除巴雷特食管（BE）对胃card门的作用尚不清楚。我们调查了完全根除IM（CEIM）后the门的肠上皮化生（IM）和不典型增生的患病率，以及EET后新诊断的IM门IM或不典型增生的发生率。方法从2013年至2016年，我们对先前成功进行EET的CEIM患者（横断面组）和未经治疗的BE进行EET的患者（纵向组）进行了一项前瞻性研究。从the门的多个层面收集标准活检标本，并进行组织学分析。我们计算了EET后IM门肌IM或发育异常的患病率（横断面组）和发生率（纵向组）。结果在横断面组的116例患者中，有17例（占15％）CEIM后出现心脏IM或发育异常：12例患有IM，2例不确定为发育异常，3例为低度不典型增生。心脏IM或发育异常最常见于胃褶皱的顶部。在纵向组的42名受试者中，of门肌IM或发育不良的治疗前患病率为28.5％（3例非发育异常IM，9发育异常IM，1发育异常不确定，2例低度发育异常，3例高水平发育不良）。级不典型增生，以及3例粘膜内癌）。都实现了CEIM。随访18个月后，IM门肌IM或发育异常的发生率为11.9％。CEIM后the门的IM或发育异常比管状食道高（P <.01）。结论在一项前瞻性研究中，我们发现card门异型增生变得更少，而不是更多，EET成功后的常见现象；card门肌的复发或异型增生比食道更常见。正在进行EET的BE患者应仔细检查card门，在胃褶的顶部进行一套活检。