摘要AIM: To investigate the roles of mucin histochemistry,cytokeratin 7/20 (CK7/20) immunoreactivity, clinical characteristics and endoscopy to distinguish shortsegment Barrett's esophageal (SSBE) from cardiac intestinal metaplasia (CIM).METHODS: High iron diamine/Alcian blue (HID/AB)mucin-histochemical staining and immunohistochemical staining were used to classify intestinal metaplasia (IM)and to determine CK7/20 immunoreactivity pattern in SSBE and CIM, respectively, and these results were compared with endoscopical diagnosis and the positive rate of gastroesophageal reflux disease (GERD)symptoms and H pylori infection. Long-segment Barrett's esophageal and IM of gastric antrum were designed as control.RESULTS: The prevalence of type Ⅲ IM was significantly higher in SSBE than in CIM (63.33% vs23.08%, P＜0.005). The CK7/20 immunoreactivity in SSBE showed mainly Barrett's pattern (76.66%), and the GERD symptoms in most cases which showed Barrett's pattern were positive, whereas H pylori infection was negative. However, the CK7/20 immunoreactivity in CIM was gastric pattern preponderantly (61.54%), but there were 23.08% cases that showed Barrett's pattern. H pylori infection in all cases which showed gastric pattern was significantly higher than those which showed Barrett's pattern (63.83% vs 19.30%, P＜0.005), whereas the GERD symptoms in gastric pattern were significantly lower than that in Barrett's pattern (21.28% vs 85.96%,P＜0.005).CONCLUSION: Distinction of SSBE from CIM should not be based on a single method;however, the combination of clinical characteristics, histology, mucin histochemistry,CK7/20 immunoreactivity, and endoscopic biopsy should be applied. Type Ⅲ IM, presence of GERD symptoms,and Barrett's CK7/20 immunoreactivity pattern may support the diagnosis of SSBE, whereas non-type Ⅲ IM, positive H pylori infection, and gastric CK7/20immunoreactivity pattern may imply CIM.