儿童和青少年中无神经发育或气管食管异常的 Barrett 食管：一项前瞻性研究。
Barrett's esophagus in children and adolescents without neurodevelopmental or tracheoesophageal abnormalities: a prospective study.
机构信息
Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030, USA.
出版信息
Gastrointest Endosc. 2011 May;73(5):875-80. doi: 10.1016/j.gie.2011.01.017. Epub 2011 Feb 26.
BACKGROUND
Barrett's esophagus (BE) in children has been examined in retrospective studies, consisting of case series and cross-sectional studies.
OBJECTIVE
To evaluate the prevalence and determinants of BE in children who are free from neurodevelopmental disorders and tracheoesophageal abnormalities.
DESIGN
A prospective, cross-sectional study.
SETTING
Three pediatric GI Centers in Houston, Texas; Phoenix, Arizona; and Portland, Maine between February 2006 and December 2007.
PATIENTS
This study involved children and adolescents consecutively presenting for elective upper endoscopy. Patients with neurodevelopmental and tracheoesophageal disorders were excluded.
INTERVENTION
Endoscopic pictures of all cases with suspected BE were independently reviewed and verified by two experienced investigators. Esophageal biopsy specimens were obtained in all patients, and targeted biopsy specimens also were obtained from suspected BE.
MAIN OUTCOME MEASUREMENTS
Endoscopically suspected BE and histologically confirmed BE.
RESULTS
A total of 840 patients (mean age 9.5 years) were enrolled and had complete questionnaire and endoscopic data. Twelve patients were suspected of having BE (prevalence of 1.43%; 95% confidence interval [CI], 0.73-2.45), and only 1 patient had intestinal metaplasia, for a prevalence of 0.12% (95% CI, 0-0.65), whereas the rest had gastric oxyntic glands (n=6) or squamous esophageal epithelium (n=5). Patients with suspected BE had a higher mean body mass index (23.0 vs 19.1, P=.05) and more chest pain (50% vs 13%, P<.01) than patients without BE or reflux esophagitis. There was a trend toward a higher frequency of dysphagia, heartburn, and regurgitation in patients with suspected BE.
LIMITATIONS
The accuracy of BE prevalence estimates is limited by the small number of cases.
CONCLUSION
BE is rare in children without neurodevelopmental delay or tracheoesophageal anomalies presenting for elective upper endoscopy.
背景
巴雷特食管（BE）在儿童中的研究主要是回顾性研究，包括病例系列研究和横断面研究。
目的
评估无神经发育障碍和气管食管异常的儿童中 BE 的患病率和决定因素。
设计
前瞻性、横断面研究。
地点
2006 年 2 月至 2007 年 12 月期间，德克萨斯州休斯顿、亚利桑那州凤凰城和缅因州波特兰的三个儿科胃肠中心。
患者
本研究纳入连续行择期上消化道内镜检查的儿童和青少年。排除有神经发育和气管食管疾病的患者。
干预
所有疑似 BE 的病例内镜图像由两名经验丰富的调查员独立审查和验证。所有患者均行食管活检，疑似 BE 患者行靶向活检。
主要观察指标
内镜疑似 BE 和组织学确诊 BE。
结果
共纳入 840 例患者（平均年龄 9.5 岁），并完成了问卷调查和内镜检查。12 例患者疑似 BE（患病率 1.43%；95%置信区间，0.73-2.45），仅 1 例患者存在肠化生，患病率为 0.12%（95%置信区间，0-0.65），其余患者为胃底腺（n=6）或食管鳞状上皮（n=5）。疑似 BE 患者的平均体重指数（23.0 比 19.1，P=.05）和胸痛发生率（50%比 13%，P<.01）更高。疑似 BE 患者的吞咽困难、烧心和反流发生率呈升高趋势。
局限性
由于病例数量较少，BE 患病率的估计准确性受到限制。
结论
在无神经发育迟缓或气管食管异常的儿童中，择期上消化道内镜检查时 BE 罕见。
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