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The Meaning of Incidental Goblet Cells at the Gastroesophageal Junction

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Abstract

Background and Aims

The causes for the occurrence of goblet cells at the gastroesophageal junction (GEJ-GC) are unknown. The aim of our study was to compare the concurrent histologic changes of the stomach in (1) patients with GEJ-GC, but without Barrett’s esophagus (BE) to those in (2) patients with BE and in (3) controls without GEJ-GC or BE.

Methods

We used an electronic database of histopathologic records from 1.3 million individual patients, who underwent esophago-gastro-duodenoscopy (EGD) in 2009–2018. We compared the prevalence of Helicobacter pylori-positive gastritis (HpG), gastric intestinal metaplasia (G-IM), chronic inactive gastritis (CIG), and reactive gastropathy (RG) among the 3 patient groups, using odds ratios and their 95% confidence intervals.

Results

Of all EGD patients, 4.0% harbored BE and 2.4% GEJ-GC. The average age of patients with GEJ-GC (60 ± 14) was significantly younger than the age of patients with BE (63 ± 12) and significantly older than the age of controls (55 ± 17). Female subjects were more common among GEJ-GC (54%) than BE (37%), but less common than among controls (63%). The 3 gastric histopathology changes associated with H. pylori were significantly more common in GEJ-GC than BE (for HpG 2.42, 2.29–2.56; for G-IM 1.82, 1.73–1.92; for CIG 1.31, 1.22–1.41). The corresponding differences between GEJ-GC and controls were less striking (for HpG 0.97, 0.93–1.01; for G-IM 1.15, 1.11–1.19; for CIG 0.90, 0.85–0.95). RG was slightly less common in GEJ-GC than BE (0.89, 0.86–0.92) and controls (0.94, 0.91–0.96).

Conclusions

With respect to its demographic and histopathologic features, GEJ-GC likely represents gastric intestinal metaplasia as opposed to BE and should prompt gastric intestinal metaplasia screening and management.

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Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Inform Diagnostics, Irving, TX, USA

    Kevin O. Turner & Robert M. Genta

  2. Baylor College of Medicine, Houston, TX, USA

    Robert M. Genta

  3. Division of Gastroenterology, Portland VA Medical Center and Oregon Health & Science University, P3-GI, Portland, OR, 97239, USA

    Amnon Sonnenberg

Authors
  1. Kevin O. Turner
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  2. Robert M. Genta
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  3. Amnon Sonnenberg
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Contributions

RMG and AS conceived and designed the study; AS, RMG, and KOT analyzed the data and wrote the manuscript.

Corresponding author

Correspondence to Amnon Sonnenberg.

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Conflict of interest

Kevin O. Turner and Robert M. Genta are employed by Inform Diagnostics, Irving, TX. Amnon Sonnenberg has no conflict of interest to declare.

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Turner, K.O., Genta, R.M. & Sonnenberg, A. The Meaning of Incidental Goblet Cells at the Gastroesophageal Junction. Dig Dis Sci 66, 1588–1592 (2021). https://doi.org/10.1007/s10620-020-06357-5

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  • DOI: https://doi.org/10.1007/s10620-020-06357-5

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