Examination of Tissue Distribution of Helicobacter pylori Within Columnar-Lined Esophagus

H. pylori may colonize columnar-lined esophagus,although an etiologic role in esophageal adenocarcinomais unproven. H. pylori can adhere to intestinalmetaplasia in the stomach. This study was designed to examine if H. pylori adheres to specializedintestinal metaplasia in columnar-lined esophagus.Esophageal biopsies from patients with columnar-linedesophagus were reviewed. Patients with only gastric metaplasia were excluded. Sections withspecialized intestinal metaplasia in at least one thirdof at least one gland were recut, stained using theGiemsa stain, and reexamined by two independentpathologists using strict criteria for adherence by H.pylori . The 209 esophageal biopsies with adequatespecialized intestinal metaplasia from 58 patients wereexamined: H. pylori was only seen on gastric metaplasia in three patients — and never onspecialized intestinal metaplasia. Within the esophagus,H. pylori adheres only to gastric metaplasia, which isnot considered premalignant for esophagealadenocarcinoma.