Division of Gastrointestinal and Liver Diseases Department of Pathology, University of Southern California, Los Angeles, CA, USA.
Dis Esophagus. 2013 Jan;26(1):44-9. doi: 10.1111/j.1442-2050.2011.01316.x. Epub 2012 Feb 14.
Previous studies comparing the prevalence of Barrett's esophagus in Latinos and non-Latino whites are inconsistent. The aim of the study is to compare the prevalence of Barrett's esophagus in Latinos and non-Latino whites and to determine risk factors associated with Barrett's esophagus. Between March 2005 and January 2009, consecutive Latino and non-Latino white patients who underwent endoscopy for primary indication for symptoms of gastroesophageal reflux disease were identified by examining the internal endoscopy database at Los Angeles County + USC Medical Center. Barrett's esophagus was defined by columnar-lined distal esophagus on endoscopy confirmed by intestinal metaplasia on histology. Clinical features and endoscopic findings were retrospectively reviewed. The mean age of the 663 patients was 50 ± 12 years, 30% were male, and 92% were Latino. Compared with non-Latino whites, Latinos had more females (72% vs. 46%; P = 0.0001) and more Helicobacter pylori infection (53% vs. 24%; P = 0.003) but less tobacco use (7% vs. 17%; P = 0.01). Overall, 10% (68/663) of all patients had Barrett's esophagus whereas the prevalence was 10% (62/611) among the Latinos and 12% (6/52) among the non-Latino whites (OR 0.9, 95% CI 0.4-2.1; P = 0.75). One patient in the Latino group had high-grade dysplasia. On multivariate analysis, male gender (AOR 2.3, 95% CI 1.4-4.1; P = 0.002), diabetes (AOR 2.2, 95% CI 1.1-4.5; P = 0.03), and age ≥55 years (AOR 2.2, 95% CI 1.3-3.8; P = 0.006) were independently associated with Barrett's esophagus; Latino ethnicity remained nonsignificant (AOR 1.1, 95% CI 0.4-2.7; P = 0.88). In Latinos undergoing endoscopy for gastroesophageal reflux disease symptoms, the prevalence of Barrett's esophagus was 10%, comparable with non-Latino white controls as well as the prevalence previously reported among Caucasians. In addition to established risk factors, diabetes was associated with Barrett's esophagus.
先前比较拉丁裔和非拉丁裔白种人 Barrett 食管患病率的研究结果并不一致。本研究旨在比较拉丁裔和非拉丁裔白种人 Barrett 食管的患病率,并确定与 Barrett 食管相关的危险因素。2005 年 3 月至 2009 年 1 月,通过检查洛杉矶县 + USC 医疗中心的内部内窥镜数据库,确定因胃食管反流病症状而接受内窥镜检查的连续拉丁裔和非拉丁裔白人患者。Barrett 食管通过内窥镜检查确认,即存在柱状 lined 远端食管,组织学证实存在肠上皮化生。回顾性审查临床特征和内镜检查结果。663 例患者的平均年龄为 50 ± 12 岁,30%为男性,92%为拉丁裔。与非拉丁裔白人相比,拉丁裔女性更多(72%比 46%;P = 0.0001),幽门螺杆菌感染更多(53%比 24%;P = 0.003),而烟草使用更少(7%比 17%;P = 0.01)。总体而言,10%(68/663)的所有患者存在 Barrett 食管,而拉丁裔患者的患病率为 10%(62/611),非拉丁裔白人患者的患病率为 12%(6/52)(OR 0.9,95%CI 0.4-2.1;P = 0.75)。拉丁裔组中有 1 例患者存在高级别异型增生。多变量分析显示,男性(AOR 2.3,95%CI 1.4-4.1;P = 0.002)、糖尿病(AOR 2.2,95%CI 1.1-4.5;P = 0.03)和年龄≥55 岁(AOR 2.2,95%CI 1.3-3.8;P = 0.006)与 Barrett 食管独立相关;拉丁裔种族仍然无统计学意义(AOR 1.1,95%CI 0.4-2.7;P = 0.88)。在因胃食管反流病症状而接受内窥镜检查的拉丁裔人群中,Barrett 食管的患病率为 10%,与非拉丁裔白人对照组以及以前在白种人群中报道的患病率相当。除了已确定的危险因素外,糖尿病与 Barrett 食管有关。