Gashi Zaim, Ivkovski Ljube, Shabani Ragip, Haziri Adem, Juniku-Shkololli Argjira
Internal Clinic, Service of Gastrohepatology, University clinical center of Prishtina, Republic of Kosova.
Acta Inform Med. 2011 Sep;19(3):146-8. doi: 10.5455/aim.2011.19.146-148.
Barrett's esophagus (BE) is a condition in which the normal squamous epithelium of the esophagus is replaced with metaplastic intestinal-type epithelium. This epithelium can progress sequentially from metaplasia to low-grade dysplasia, then to high-grade dysplasia and finally to invasive adenocarcinoma. Many factors that appear to be risk factors for the presence of BE include obesity, the presence of hiatal hernia, and interestingly, the absence of Helicobacter pylori infection.
The aim of this study was to determine the predictive factors for progression of gastroesophageal reflux disease (GERD) to BE.
42 patients with endoscopically diagnosed and histopathologically verified BE were included in this prospective study. We analysed predictive factors such as: age, sex, obesity, alcohol consumption and smoking, reflux symptom duration in this patients, prevalence of short and long segment of BE, and the presence of hiatal hernia. After endoscopic examination of these patients, the presence of BE was verified with histopathological examination and finally, infection with H. pylori was determined.
Among 42 subjects, 25 (59%) were males and 17 (41%) were females, with mean age of 52.8±3.28 years. Obesity was present in 24 of 42 patients (57%). 27 of 42 patients (64%) were smokers. Symptom duration in this patients was approximately 9.4 years. From total number of patients, 52% were with SSBE and 48% patients were with LSBE. Hiatal hernia was present in 64% of patients, of which 66% were with LSBE and 34% with SSBE. In these patients, prevalence of infection with H. pylori was present in 12% of cases, 9.5% in patients with SSBE and 2.5% in patients with LSBE.
The important risk factors for appearance of BE in GERD patients were male sex, middle age, smooking and alcohol consumption. Obesity is an important factor for development of BE. Most of patients with BE also had hiatal hernia, in majority of cases these were patients with LSBE. The prevalence of infection with H. Pylori in patients with BE was lower and this may predict a protective role of this microorganism.
巴雷特食管（BE）是一种食管正常鳞状上皮被化生的肠型上皮取代的病症。这种上皮可依次从化生发展为低级别异型增生，进而发展为高级别异型增生，最终发展为浸润性腺癌。许多似乎是BE存在风险因素的因素包括肥胖、食管裂孔疝的存在，有趣的是，还包括幽门螺杆菌感染的缺失。
本研究的目的是确定胃食管反流病（GERD）进展为BE的预测因素。
本前瞻性研究纳入了42例经内镜诊断和组织病理学证实为BE的患者。我们分析了预测因素，如：年龄、性别、肥胖、饮酒和吸烟情况、这些患者的反流症状持续时间、短段和长段BE的患病率以及食管裂孔疝的存在情况。在对这些患者进行内镜检查后，通过组织病理学检查证实BE的存在，最后确定幽门螺杆菌感染情况。
42名受试者中，25名（59%）为男性，17名（41%）为女性，平均年龄为52.8±3.28岁。42例患者中有24例（57%）存在肥胖。42例患者中有27例（64%）吸烟。这些患者的症状持续时间约为9.4年。在所有患者中，52%为短段BE，48%为长段BE。64%的患者存在食管裂孔疝，其中66%为长段BE患者，34%为短段BE患者。在这些患者中，幽门螺杆菌感染的患病率为12%，短段BE患者中为9.5%，长段BE患者中为2.5%。
GERD患者出现BE的重要风险因素为男性、中年、吸烟和饮酒。肥胖是BE发生的一个重要因素。大多数BE患者也有食管裂孔疝，在大多数情况下，这些是长段BE患者。BE患者中幽门螺杆菌感染的患病率较低，这可能预示着这种微生物具有保护作用。
