BACKGROUND: To investigate the factors leading to histologic regression of metaplastic and @entity355 ( @entity355 ). STUDY DESIGN: The study sample consisted of 91 consecutive @entity1 with symptomatic @entity355 . Pre- and posttreatment endoscopic biopsies from 77 Barrett's @entity1 treated surgically and 14 treated with proton pump inhibitors (PPI) were reviewed. An expert pathologist confirmed the presence of intestinal metaplasia (IM) with or without @entity1141 . Posttreatment histology was classified as having regressed if two consecutive biopsies taken more than 6 months apart plus all subsequent biopsies showed loss of IM or loss of @entity1141 . Clinical factors associated with regression were studied by multivariate analysis, as was the time course of its occurrence. RESULTS: Histopathologic regression occurred in 28 of 77 @entity1 (36.4%) after antireflux surgery and in 1 of 14 @entity1 (7.1%) treated with PPIs alone (p < 0.03). After surgery, regression from low-grade dysplastic to nondysplastic @entity355 occurred in 17 of 25 @entity1 (68%) and from IM to no IM in 11 of 52 (21.2%). Both types of regression were significantly more common in short (< 3 cm) than long (> 3 cm) segment @entity355 ; 19 of 33 (58%) and 9 of 44 (20%) @entity1 , respectively (p = 0.0016). Eight @entity1 progressed, five from IM alone to low-grade @entity1141 and three from low- to high-grade @entity1141 . All those who progressed had long segment @entity355 . On multivariate analysis, presence of short segment Barrett's and type of treatment were significantly associated with regression; age, gender, surgical procedure, and preoperative lower esophageal sphincter and pH characteristics were not. The median time of biopsy-proved regression was 18.5 months after surgery, with 95% occurring within 5 years. CONCLUSIONS: This study refutes the widely held assumption that once established, @entity355 does not change. More than one-third of @entity1 with visible segments of @entity355 undergo histologic regression after antireflux surgery. Regression is dependent on the length of the columnar-lined esophagus and time of followup after antireflux surgery.

XXXX can and does regress after antireflux surgery: a study of prevalence and predictive features.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1141 :: ('MESH:C535662', 'Disease') :: ['dysplasia'] @entity355 :: ('MESH:D001471', 'Disease') :: ["dysplastic Barrett's esophagus", 'BE', "Barrett's esophagus"]
@entity355 :: (MESH:D001471,Disease) :: ['Barrett's esophagus']
