布拉格C和M标准在华裔人群巴雷特食管诊断中的应用。

The application of Prague C and M criteria in the diagnosis of Barrett's esophagus in an ethnic Chinese population.

作者信息

Chang Chi-Yang, Lee Yi-Chia, Lee Ching-Tai, Tu Chia-Hung, Hwang Jau-Chung, Chiang Hung, Tai Chi-Ming, Chiang Tsung-Hsien, Wu Ming-Shiang, Lin Jaw-Town

机构信息

Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.

出版信息

Am J Gastroenterol. 2009 Jan;104(1):13-20. doi: 10.1038/ajg.2008.43.

DOI:10.1038/ajg.2008.43

PMID:19098843

Abstract

OBJECTIVES

To investigate the prevalence of endoscopically suspected esophageal metaplasia (ESEM) in an ethnic Chinese population by endoscopic and pathologic evaluation and to assess the utility of Prague C and M criteria.

METHODS

Consecutive patients who received esophagogastroduodenoscopy either as a part of therapy for various upper abdominal symptoms or as an annual health check-up were evaluated for the existence of ESEM and Barrett's esophagus (BE). Biopsy with standardized random four pieces every 2 cm from the four quarters of esophagus with ESEM lesion was performed. BE was defined by histological verification of specialized intestinal metaplasia and gastric metaplasia and was categorized according to the Prague C and M criteria.

RESULTS

A total of 5,179 subjects were screened from Jan. 2007 to Dec. 2007. This study enrolled 4,797, including 3,386 for referral endoscopy and 1,411 for screening endoscopy. Prevalence of BE among the referral endoscopy, screening endoscopy, and overall was 1.06%, 0.35%, and 0.85%, respectively. A total of 41 subjects with BE were detected among 93 ESEM subjects. Short segment BE (75.6%, n=31) was more prevalent than long segment BE (24.4%, n=10). The proportions of BE from subjects with ESEM by Prague C and M criteria were C< or =1M1 38.9% (19/50), C< or =1M2 40% (12/30), and CxM> or =3 76.9% (10/13).

CONCLUSIONS

On the basis of the standardized protocol with random four-quadrate endoscopic biopsy, we have demonstrated the utility of Prague C and M criteria to characterize the BE in an ethnic Chinese population.

摘要

目的

通过内镜及病理评估，调查中国汉族人群中内镜疑似食管化生（ESEM）的患病率，并评估布拉格C和M标准的实用性。

方法

对因各种上腹部症状接受食管胃十二指肠镜检查或作为年度健康体检一部分的连续患者进行ESEM和巴雷特食管（BE）的评估。对有ESEM病变的食管四个象限每隔2cm进行标准化随机取四块活检。BE通过特殊肠化生和胃化生的组织学验证来定义，并根据布拉格C和M标准进行分类。

结果

2007年1月至2007年12月共筛查了5179名受试者。本研究纳入4797名，其中3386名接受转诊内镜检查，1411名接受筛查内镜检查。转诊内镜检查、筛查内镜检查及总体人群中BE的患病率分别为1.06%、0.35%和0.85%。在93名ESEM受试者中，共检测到41名BE患者。短段BE（75.6%，n = 31）比长段BE（24.4%，n = 10）更常见。根据布拉格C和M标准，ESEM受试者中BE的比例分别为C≤1M1 38.9%（19/50）、C≤1M2 40%（12/30）和CxM≥3 76.9%（10/13）。