Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Dig Dis Sci. 2010 May;55(5):1337-43. doi: 10.1007/s10620-009-0872-7. Epub 2009 Jun 26.
There is a paucity of epidemiologic data concerning Barrett's esophagus (BE) in Taiwan.
This study aimed to investigate the frequency of and risk factors for BE in self-referred Taiwanese patients undergoing diagnostic endoscopy.
A total of 736 consecutive patients undergoing upper endoscopy for a variety of gastro-intestinal symptoms from February to October 2007 were evaluated. A standard questionnaire was used to record the clinical characteristics and patient symptoms. Gastro-esophageal reflux disease (GERD) was diagnosed using the Montreal definition, while the Los Angeles Classification and Prague Circumferential and Maximal Criteria were used to assess erosive esophagitis and BE, respectively. Four-quadrant biopsies were taken from endoscopically suspected esophageal metaplastic mucosa every 2 cm for histologic evaluation. Eight variables were tested using a logistic regression model to identify risk factors for BE in GERD patients.
GERD was diagnosed in 344 patients, with typical esophageal symptoms noted in 255, reflux chest pain syndrome in 107, and extra-esophageal syndrome in 51, while 27 were asymptomatic. The mean age of the GERD patients was 49.8 years and 55.5% of them were male. Thirty-six percent (123 of 344) demonstrated erosive esophagitis and 95% were classified as having Los Angeles grade A or B disease. BE was diagnosed in 13 patients (3.8% of GERD patients), three of whom had dysplastic mucosa. In the final analysis model, hiatal hernia (odds ratio [OR] = 4.7, 95% confidence interval [CI] = 1.3-17.7, P = 0.02) and GERD duration >5 years (OR = 4.2, 95% CI = 1.2-4.8, P = 0.03) were independent risk factors for the development of BE.
There is a 3.8% frequency of BE in Taiwanese GERD patients. Hiatal hernia and prolonged GERD duration are significant risk factors.
台湾地区 Barrett 食管（BE）的流行病学数据较少。
本研究旨在调查在接受诊断性内镜检查的自行就诊的台湾患者中 BE 的频率和危险因素。
对 2007 年 2 月至 10 月间因各种胃肠道症状接受上消化道内镜检查的 736 例连续患者进行评估。使用标准问卷记录临床特征和患者症状。胃食管反流病（GERD）采用蒙特利尔定义诊断，洛杉矶分类和布拉格环周和最大标准分别用于评估糜烂性食管炎和 BE。在内镜怀疑的食管化生黏膜的每 2 cm 处取四个象限活检进行组织学评估。使用逻辑回归模型测试 8 个变量，以确定 GERD 患者发生 BE 的危险因素。
诊断出 344 例 GERD，其中 255 例有典型食管症状，107 例有反流性胸痛综合征，51 例有食管外综合征，而 27 例无症状。GERD 患者的平均年龄为 49.8 岁，其中 55.5%为男性。36%（344 例中的 123 例）表现为糜烂性食管炎，95%的患者为洛杉矶 A 或 B 级疾病。诊断出 13 例 BE（GERD 患者的 3.8%），其中 3 例有异型增生黏膜。在最终分析模型中，食管裂孔疝（比值比[OR] = 4.7，95%置信区间[CI] = 1.3-17.7，P = 0.02）和 GERD 持续时间>5 年（OR = 4.2，95%CI = 1.2-4.8，P = 0.03）是发生 BE 的独立危险因素。
台湾 GERD 患者中 BE 的发生率为 3.8%。食管裂孔疝和 GERD 持续时间延长是显著的危险因素。
