Prevalence and Clinical and Endoscopic Characteristics of Cervical Inlet Patch (Heterotopic Gastric Mucosa)

Abstract

Background: Cervical inlet patch (CIP), also called gastric inlet patch, is a heterotopic columnar mucosal island located in the cervical esophagus, which has been under-recognized by clinicians.Aim: We conducted a systemic review and meta-analysis to explore the prevalence and clinical and endoscopic characteristics of CIP.Materials and Methods: Studies were searched through the PubMed, EMBASE, and Cochrane Library databases. The prevalence of CIP with 95% confidence interval (CI) was pooled by using a randomeffect model. The association of CIP with demographics, clinical presentations, and endoscopic features was evaluated by odds ratios (ORs).Results: Fifty-three studies including 932,777 patients were eligible. The pooled prevalence of CIP was 3.32% (95% CI = 2.86%-3.82%). According to the endoscopic mode, the pooled prevalence of CIP was higher in studies using narrow-band imaging than in those using white light and esophageal capsule endoscopy (9.34% vs. 2.88% and 0.65%). The pooled prevalence of CIP was higher in studies where the endoscopists paid specific attention to the detection of this lesion (5.30% vs. 0.75%). CIP was significantly associated with male (

Cervical Esophageal Adenocarcinoma Arising From Gastric Inlet Patch: A Benign Lesion With Malignant Potential

“…4 In addition, slow withdrawal of the endoscope has also been shown to improve the detection of GIP. 4 There are no established screening guidelines for ectopic gastric mucosa, and routine biopsies are not recommended because preneoplasia within GIP is rare. 9 Concerning endoscopic features for malignancy include polypoid or infiltrative lesions, stricture formation, or ulceration within the cervical esophagus.…”

“…Other modalities including blue laser imaging, i-Scan, and Fuji intelligent chromoendoscopy appear to have similar advantages in detecting such lesions. 4 In addition, slow withdrawal of the endoscope has also been shown to improve the detection of GIP. 4 There are no established screening guidelines for ectopic gastric mucosa, and routine biopsies are not recommended because preneoplasia within GIP is rare.…”

Ablation of cervical inlet patch for the treatment of globus sensation: A case report

“…1 The histology of CIP also lends itself to acid reflux related findings, including esophagitis, esophageal stricture, esophageal perforation, and rarely, progression to Barrett's esophagus and adenocarcinoma. [1][2][3][4] Many symptoms associated with CIP overlap with LPR, including globus sensation (1.6%-78.6%), dysphagia (15.2%-39.4%), and chronic cough (29.2%). 2,5 We report on a case of refractory globus sensation determined to be due to a CIP, as well as a new treatment technique using carbon dioxide (CO2) laser ablation with a Weerda laryngoscope.…”

“…Cervical inlet patch (CIP) represents an island of heterotopic gastric mucosa typically located in the proximal esophagus, with an estimated prevalence rate of 0.1%–18.0% 1 . Due to its proximity to the hypopharynx and larynx, CIP may present with symptoms similar to laryngopharyngeal reflux (LPR), while others can be asymptomatic 1 .…”

“…Cervical inlet patch (CIP) represents an island of heterotopic gastric mucosa typically located in the proximal esophagus, with an estimated prevalence rate of 0.1%–18.0% 1 . Due to its proximity to the hypopharynx and larynx, CIP may present with symptoms similar to laryngopharyngeal reflux (LPR), while others can be asymptomatic 1 . The histology of CIP also lends itself to acid reflux related findings, including esophagitis, esophageal stricture, esophageal perforation, and rarely, progression to Barrett's esophagus and adenocarcinoma 1–4 .…”