Related Experiment Video
Updated: Jun 18, 2026

Establishment and Evaluation of a Risk Prediction Model for Pathological Escalation of Gastric Low-Grade Intraepithelial Neoplasia
Published on: February 16, 2024
Predictors of specialized intestinal metaplasia in patients with an incidental irregular Z line
Ram Dickman1, Zohar Levi, Alex Vilkin
1Department of Gastroenterology, Rabin Medical Center, Beilinson Hospital, Tel Aviv University, Israel.
Introduction:
Barrett's esophagus is a well-known complication of gastroesophageal reflux disease (GERD) and is associated with dysplasia and esophageal adenocarcinoma. Data on the prevalence of specialized intestinal metaplasia (SIM) in biopsy taken from an incidental irregular Z line are scarce.
Aim:
To determine the prevalence of SIM in biopsies taken from an incidental irregular Z line in consecutive patients undergoing upper endoscopy.
Methods:
During the study period, we identified all adult patients who underwent an upper endoscopy with biopsies from an incidental finding of an irregular Z line. Demographic characteristics, prevalence of endoscopic findings, and major complaints were compared between those with SIM and those without.
Results:
A total of 166 out of 2000 (8.3%) consecutive patients were identified. Specialized intestinal metaplasia was found in 43.5% of all cases. Male sex and the presence of hiatus hernia were predictors of SIM (P=0.043 and 0.001, respectively), with relative risks of 2.02 (95% confidence interval: 1.01-4.0) and 3.31 (95% confidence interval: 1.66-6.58), respectively.
Conclusion:
In this endoscopic and histological study, SIM was found to be a common finding in patients with irregular Z line. Male sex and the presence of diaphragmatic hernia were significantly associated with the presence of SIM.
Related Concept Videos
Cellular Adaptation IV: Dysplasia and Metaplasia
Renewal of Intestinal Stem Cells
Histology of the Small Intestine
The intestinal lining features transverse folds called circular folds, each housing fingerlike projections known as intestinal villi. These villi are covered by a layer of simple columnar epithelium, also referred to as...
Barrett Esophagus-I: Introduction
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more similar...
Inflammatory Bowel Disease III: Crohn's Disease
