The clinical endoscopic and histological characteristics of heterotopic gastric mucosa in upper esophagus Wang Jiaqi, Xiang Lizhi, Pan Xiaoli, Yu Xiaoyun, Hou Xiaohua Department of Gastroenterology, Union Hospital Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China Corresponding author: Yu Xiaoyun, Email: xhyuxy@163.com 【Abstract】 Objective To study the clinical endoscopic and histological characteristics of heterotopic gastric mucosa in upper esophagus. Methods The cases in the HGMUE group of this study were from patients who underwent gastroscopy at the Endoscopy Center of Wuhan Union Hospital from January 2017 to December 2017 and were diagnosed with HGMUE; Gastroesophageal Reflux Symptom Questionnaire (GERD-Q) was performed on patients, according to the GERD-Q scores and whether there is a heterotopic gastric mucosa in upper esophagus under endoscopy, the patients were divided into the HGMUE group（GERD-Q<8分，n=101）and GERD+HGMUE group（GERD-Q≥8分，n=76）. The data of clinical endoscopic and histological characteristics were ummarized and analyzed. Results Among the 177 HGMUE cases, there were 111 males (62.71%) and 66 females (37.29%),HGMUE+GERD group 76(42.94%),HGUME without GERD group 101(57.06%); The most common symptoms in all HGMUE patients were clearing your throat[54.24%（96/177）],and sensations of something sticking in your throat or a lump in your throat[48.59%（86/177)],and gastroesophageal reflux symptoms such as heartburn, chest pain, indigestion, acid reflux[48.59%(86/177)].In HGMUE without GERD group,the occurrence rate of clearing your throat was highest[42.57%（43/101）],then sensations of something sticking in your throat or a lump in your throat was 33.66%（34/101),and gastroesophageal reflux symptoms such as heartburn, chest pain, indigestion, acid reflux was 27.72%（28/101).In HGUME+GERD group,the most common symptoms were gastroesophageal reflux symptoms[76.32%(58/76)],then clearing your throat [69.74%(53/76)]and sensations of something sticking in your throat or a lump in your throat[68.42%（52/76)]. Under gastroscopy,the heterotopic gastric mucosas usually appeared as orange-red round, oval or elongated island lesions, most of them were flat and a few slightly protruded from the peripheral plane.There were 132 (74.58%) single lesions, 38 (21.47%) 2 lesions, 7 (3.95%) 3 or more lesions; 37 (20.9%) small lesions (maximum diameter < 0.5 cm), 74 (41.8%) midden lesions(maximum diameter of 0.5-1.0 cm), and 66 (37.3%) larger lesions (maximum diameter >1.0 cm).Among the 30 samples of mucosal tissue[16.95%（30/177)], 15 samples showed mainly cardia gland[50.00%（15/30)], 8 samples showed mainly pyloric gland[26.67%（8/30)], 6 samples showed mixed type[20.00%（6/30)], and 1 was squamous epithelium[3.33%（1/30)].In the immunohistochemical test, 20 cases [66.67% (20/30)] H+-K+-ATPase showed positive,10 cases [33.33% (10/30)] were negative. Conclusion HGMUE is more common in male patients, and may be combined with GERD.Among them, patients with combined GERD are more likely to develop laryngopharyngeal reflux .Under gastroscopy,the heterotopic gastric mucosas usually appeared as orange-red round, oval or elongated island lesions, most of them were flat,single and midden or large size.Histological types were mostly fundic glands, and H+-K+-ATPase postive was more common. It is speculated that acid secretion may be an important factor leading to throat symptoms. 【Key words】Gastroesophageal reflux; Heterotopic gastric mucosa in upper esophagus; Laryngopharyngeal reflux; Acid secretion