Lao Christopher D, Simmons Melanie, Syngal Sapna, Bresalier Robert S, Fortlage Laurie, Normolle Daniel, Griffith Kent A, Appelman Henry D, Brenner Dean E
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.
Cancer. 2004 Apr 15;100(8):1622-7. doi: 10.1002/cncr.20149.
Dysplasia in Barrett esophagus is a premalignant condition that is associated with an increased risk of developing esophageal adenocarcinoma. Unfortunately, clinical investigation aimed at prevention of progression to malignant disease has been hampered by the variable prevalence of dysplasia reported in the literature. The objective of the current study was to more accurately determine the prevalence of dysplasia among individuals with Barrett esophagus who would be available for enrollment in a chemoprevention trial.
The pathology archives of 3 institutions were reviewed over a 5-year period for all reports of diagnoses of Barrett esophagus. Surgical cases, malignancies, and duplicate or referral cases were excluded from the analysis.
A total of 790 cases of Barrett esophagus were identified. Of these, 37 (4.7%) were cases of low-grade dysplasia (LGD), and 20 (2.5%) were cases of high-grade dysplasia. The University of Michigan Medical Center (Ann Arbor, MI) diagnosed 18 cases of LGD, Henry Ford Hospital (Detroit, MI) diagnosed 15 cases of LGD, and Brigham and Women's Hospital (Boston, MA) diagnosed 4 cases of LGD in patients with Barrett esophagus over the 5-year study period.
The confirmed low prevalence of cases of LGD will affect the design of future clinical trials of chemopreventive interventions for Barrett esophagus.
巴雷特食管发育异常是一种癌前病变，与食管腺癌发生风险增加相关。遗憾的是，针对预防进展为恶性疾病的临床研究因文献报道的发育异常患病率存在差异而受到阻碍。本研究的目的是更准确地确定可纳入化学预防试验的巴雷特食管患者中发育异常的患病率。
回顾了3家机构5年期间所有巴雷特食管诊断报告的病理档案。分析排除了手术病例、恶性肿瘤以及重复或转诊病例。
共识别出790例巴雷特食管病例。其中，37例（4.7%）为低级别发育异常（LGD），20例（2.5%）为高级别发育异常。在5年研究期间，密歇根大学医学中心（密歇根州安娜堡）诊断出18例LGD，亨利·福特医院（密歇根州底特律）诊断出15例LGD，布莱根妇女医院（马萨诸塞州波士顿）诊断出4例巴雷特食管患者的LGD。
确诊的LGD病例低患病率将影响未来巴雷特食管化学预防干预临床试验的设计。
