Division of Gastroenterology, University of Florida/Jacksonville, Jacksonville, FL, USA.
Dig Dis Sci. 2012 Feb;57(2):419-23. doi: 10.1007/s10620-011-1900-y. Epub 2011 Sep 11.
Barrett's Esophagus (BE) is a pre-malignant condition. Limited data on BE dysplasia prevalence exists among United States ethnic groups.
The purpose of this study was to determine if the frequency of BE with dysplasia varies among the major ethnic groups presenting to our institution.
The University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002 to August 2007. Histologic BE was diagnosed if salmon colored esophageal mucosa was endoscopically seen at least 1 cm above the top of the gastric folds and biopsy revealed intestinal metaplasia with Alcian blue-containing goblet cells. Demographic data collected for all included: age at diagnosis, ethnicity, sex, previous history of esophageal reflux, atypical manifestations (chronic cough, aspiration), endoscopic length of BE, presence or absence of hiatal hernia, esophageal stricture or ulcer, and presence or absence of dysplasia.
Salmon colored esophageal mucosa was observed in 405 of 7,308 patients (5.5%) and histologically confirmed in 115 of 405 patients (28%) reflecting an overall prevalence of BE of 115/7308 (1.6%) in this cohort. Ethnic distribution of histologic BE patients was as follows: 95 (83%) non-Hispanic white (nHw), 16 (14%) African American (AA) and 4 (3%) other. Long segment BE (LSBE) and any form of dysplasia was observed less frequently in AA than nHw (LSBE: 12% vs. 26% and dysplasia: 0% vs. 7%).
LSBE and dysplasia are less frequent in AA than nHw. Studies in AA with BE may illustrate factors limiting dysplasia and LSBE risk.
巴雷特食管（BE）是一种癌前病变。在美国的不同种族群体中，有关 BE 异型增生的患病率的数据有限。
本研究旨在确定在我们机构就诊的主要种族群体中，BE 伴异型增生的频率是否存在差异。
检索了 2002 年 9 月至 2007 年 8 月间佛罗里达大学杰克逊维尔分校的内镜数据库，以确定所有内镜诊断为 BE 的病例。如果在胃皱襞顶端上方至少 1cm 处看到鲑鱼色食管黏膜，并活检显示肠化生，且含有含蓝的杯状细胞，则诊断为组织学 BE。为所有纳入的病例收集了人口统计学数据：诊断时的年龄、种族、性别、食管反流的既往史、非典型表现（慢性咳嗽、吸入）、BE 的内镜长度、是否存在食管裂孔疝、食管狭窄或溃疡以及是否存在异型增生。
在 7308 例患者中，有 405 例（5.5%）观察到鲑鱼色食管黏膜，其中 115 例（28%）经组织学证实，这反映了该队列中 BE 的总体患病率为 115/7308（1.6%）。组织学 BE 患者的种族分布如下：95 例（83%）为非西班牙裔白人（nHw），16 例（14%）为非裔美国人（AA），4 例（3%）为其他种族。AA 中长段 BE（LSBE）和任何形式的异型增生的发生率均低于 nHw（LSBE：12% vs. 26%和异型增生：0% vs. 7%）。
AA 中 LSBE 和异型增生的发生率低于 nHw。对 AA 中 BE 的研究可能会阐明限制异型增生和 LSBE 风险的因素。
