Peitz U, et al. – This research was designed to prospectively define the prevalence of inlet patch (IP) and of preneoplasia within IP, and to examine the relationship between IP and Barrett’s esophagus. The prevalence of IP appeared to be undervalued, but preneoplasia within IP was rare, which did not support the proposal to regularly obtain biopsies for histopathology. Biopsies needed to target to any irregularities within the heterotopic mucosa. The relationship of IP with Barrett’s esophagus hinted to a partly common pathogenesis.

Methods

• The clinicians carefully searched 372 consecutive patients undergoing esophagogastroduodenoscopy for the presence of IP.
• They targeted biopsies for histopathology to the IP, columnar metaplasia of the lower esophagus, gastric corpus and antrum.
• They tested different definitions of Barrett’s esophagus for an association with IP.

Results

• The clinicians endoscopically identified at least 1 IP in 53 patients (14.5%).
• In this study, histopathology, performed in 46 patients, confirmed columnar epithelium in 87% of cases, which essentially presented corpus and/or cardia-type mucosa.
• They detected intestinal metaplasia in 2 cases, but no neoplasia.
• As per the outcomes, a previously reported association of IP with Barrett’s esophagus was weak, statistically significant only when short segments of the cardia-type mucosa of the lower esophagus were included in the definition of Barrett’s esophagus.