Prevalence of and risk factors for Barrett's esophagus with intestinal predominant mucin phenotype

Barrett's esophagus with the intestinal predominant mucin phenotype is considered to have a higher malignant potential than that with the gastric predominant mucin phenotype. The purpose of this prospective study was to investigate the prevalence of and risk factors for Barrett's esophagus with the intestinal predominant mucin phenotype in patients undergoing endoscopy.

A total of 1699 consecutive patients undergoing esophagogastroduodenoscopy were enrolled in the study. A targeted biopsy was performed when endoscopically observed columnar-appearing esophagus was stained with crystal violet. The sample, histologically evidenced as Barrett's esophagus, was immunohistochemically evaluated and categorized as of either gastric or intestinal predominant mucin phenotype. All the patients were requested to complete the structured questionnaire indicating their symptoms and food consumption patterns. Prevalence of and risk factors for Barrett's esophagus with and without the intestinal predominant mucin phenotype were investigated.

Out of 1668 patients, 629 (37.7%) were found to have endoscopic Barrett's esophagus. In 333 out of 1668 patients (19.9%), histological studies were diagnostic of Barrett's esophagus. One hundred and six of these 333 patients (31.8%) had the intestinal predominant mucin phenotype. Age, male gender and the presence of hiatal hernia were confirmed by multivariate analysis as the independent predictors for the presence of Barrett's esophagus with the intestinal predominant mucin phenotype.

Barrett's esophagus with the intestinal predominant mucin phenotype was immunohistochemically found in 6.4% of all study patients. Older age, male gender and the presence of hiatal hernia were the risk factors for the presence of Barrett's esophagus with the intestinal predominant mucin phenotype.