UK Barrett's Oesophagus Registry, UCL Department of Surgery and Interventional Science, Royal Free Hospital, London, UK.
Endoscopy. 2012 Oct;44(10):892-8. doi: 10.1055/s-0032-1309842. Epub 2012 Jul 2.
There is a view that the majority of deaths in patients with Barrett's esophagus are from causes other than esophageal adenocarcinoma (EAC). The aim of this analysis was to establish the pattern of mortality for a number of causes in patients with Barrett's esophagus.
This was a single-center prospective cohort study of patients from Rotherham District General Hospital, which is a secondary referral center. The cohort consisted of 1239 patients who were diagnosed with Barrett's esophagus between April 1978 and March 2009. Follow-up for mortality was undertaken by "flagging" the patients with the NHS Information Center. Causes of death were compared with UK Office of National Statistics age- and sex-specific mortality data for 1999, the median year of diagnosis. Analysis was by a "person - years at risk" calculation from date of diagnosis.
The ratio of observed deaths from EAC compared with those expected in this cohort was 25.02 - a very large excess. There was no difference in mortality from colorectal cancer or circulatory disease and there were fewer deaths from cancers other than esophageal adenocarcinoma and colon cancer compared with national statistics. There was a small statistically significant difference in mortality from all causes but this disappeared completely when deaths from esophageal adenocarcinoma were excluded.
Overall, mortality in Barrett's esophagus is increased significantly but only as a result of the large excess of deaths from EAC. This strengthens the case for endoscopic surveillance if successful interventions can be undertaken in patients with Barrett's esophagus to prevent development of esophageal adenocarcinoma.
有一种观点认为，大多数 Barrett 食管患者的死亡原因并非食管腺癌（EAC）。本分析旨在确定 Barrett 食管患者多种死因的死亡模式。
这是罗瑟勒姆地区综合医院的一项单中心前瞻性队列研究，该医院是一家二级转诊中心。该队列包括 1239 名于 1978 年 4 月至 2009 年 3 月期间被诊断为 Barrett 食管的患者。通过 NHS 信息中心“标记”患者来进行死亡率随访。将死因与英国国家统计局 1999 年（中位诊断年份）的年龄和性别特定死亡率数据进行比较。分析采用“人-年风险”计算方法，从诊断日期开始计算。
本队列中观察到的 EAC 死亡人数与预期死亡人数之比为 25.02-明显过多。结直肠癌或循环系统疾病的死亡率没有差异，与国家统计数据相比，除食管腺癌和结肠癌以外的癌症死亡率较低。所有原因的死亡率存在统计学上的微小差异，但如果可以对 Barrett 食管患者进行成功的干预以预防食管腺癌的发生，那么 EAC 死亡人数除外，这种差异就会完全消失。
总体而言， Barrett 食管的死亡率显著增加，但这仅仅是由于 EAC 死亡人数过多所致。这加强了对 Barrett 食管进行内镜监测的理由，如果可以对 Barrett 食管患者进行成功的干预以预防食管腺癌的发生，那么就可以进行这种监测。
