Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
J Gastroenterol. 2011 Mar;46(3):332-8. doi: 10.1007/s00535-010-0353-y. Epub 2010 Dec 4.
Barrett's esophagus has been divided into three categories based on the extent of the metaplasia: long-segment (LSBE), short-segment (SSBE), and ultrashort-segment Barrett's esophagus (USBE). While both LSBE and SSBE are thought to be induced by gastroesophageal reflux, the etiology of USBE is still unclear.
We conducted a case-control study to identify the differences in the pathogenesis between SSBE and USBE in a hospital-based population. The endoscopic findings and clinical factors of 199 patients with short-segment endoscopically suspected esophageal metaplasia (SS-ESEM) and 317 patients with ultrashort-segment ESEM (US-ESEM) were compared with those of 199 and 317 age- and gender-matched patients without ESEM.
The severity of gastric mucosal atrophy was marginally associated with the presence of US-ESEM [odds ratio (OR) 1.20, 95% confidence interval (CI) 0.98-1.46, p = 0.08], but not with that of SS-ESEM. On the other hand, the presence of gallstones and that of severe reflux esophagitis were associated with the presence of SS-ESEM (OR 2.19, 95% CI 1.21-3.98; OR 1.72, 95% CI 1.08-2.75), but not with that of US-ESEM. Presence of gastric corpus atrophy without gallstones was associated with the presence of US-ESEM, but not with that of SS-ESEM.
Presence of gastric corpus atrophy was associated with an increased likelihood of the presence of US-ESEM, whereas the presence of gallstones was associated with an increased likelihood of the presence of SS-ESEM, suggesting difference in etiology between US- and SS-ESEM.
巴雷特食管根据化生的范围分为三类：长节段（LSBE）、短节段（SSBE）和超短节段 Barrett 食管（USBE）。虽然 LSBE 和 SSBE 都被认为是由胃食管反流引起的，但 USBE 的病因仍不清楚。
我们进行了一项病例对照研究，以确定医院人群中 SSBE 和 USBE 发病机制的差异。比较了 199 例短节段内镜疑似食管化生（SS-ESEM）和 317 例超短节段 ESEM（US-ESEM）患者的内镜表现和临床因素与 199 例和 317 例年龄和性别匹配的无 ESEM 患者。
胃黏膜萎缩的严重程度与 US-ESEM 的存在呈边缘相关（比值比 [OR] 1.20，95%置信区间 [CI] 0.98-1.46，p = 0.08），但与 SS-ESEM 无关。另一方面，胆囊结石和严重反流性食管炎的存在与 SS-ESEM 的存在相关（OR 2.19，95%CI 1.21-3.98；OR 1.72，95%CI 1.08-2.75），但与 US-ESEM 无关。无胆囊结石的胃体萎缩与 US-ESEM 的存在相关，但与 SS-ESEM 无关。
胃体萎缩的存在与 US-ESEM 存在的可能性增加相关，而胆囊结石的存在与 SS-ESEM 存在的可能性增加相关，提示 US-ESEM 和 SS-ESEM 的病因不同。
