Katsinelos P, Lazaraki G, Kountouras J, Chatzimavroudis G, Zavos C, Terzoudis S, Tsiaousi E, Gkagkalis S, Trakatelli C, Bellou A, Vasiliadis T
Department of Endoscopy and Motility Unit, G. Gennimatas General Hospital, Thessaloniki, Greece.
Hippokratia. 2013 Jan;17(1):27-33.
Barrett's esophagus(BE) is a premalignant condition associated with chronic gastro-esophageal reflux disease (GERD). As only a small proportion of BE progresses to malignancy, it is important to study BE prevalence to prevent adenocarcinoma.
Between January 2007 and December 2010, all consecutive individuals who underwent routine upper endoscopy were prospectively recruited. Patients referred for GERD were excluded from the study. Clinical and endoscopic data were collected.
A total of 1,990 patients (mean age 47.48±13.4 years; 52.8% males) were included. Of them, 496 (24.9%) reported GERD. Erosive esophagitis (EE) was found in 221 participants (11.1%, 193 patients with LA grade A and 28 patients with LA grade B). Overall 31 of 1494 participants not reporting reflux symptoms (2.07%) suffered from silent GERD. BE was diagnosed in 75 participants (3.77%), four (5.3%) with long-segment BE and 71 (94.7%) with short-segment BE. Low-grade dysplasia was noticed in 1 patient with long-segment BE. Hiatal hernia (HH) was found in 196 patients (9.8%), and mean HH length was 3.22 ± 0.2 cm. BE was correlated to EE, GERD and the presence of HH (p= 0.0167, <0.001 and 0.017, respectively) whereas it was not associated with age, alcohol consumption and smoking (p= 0.057, 0.099 and 0.06, respectively). BE was not correlated with Helicobacter pylori infection (p=0.542).
The prevalence of BE was 3.77% in a Greek population undergoing upper endoscopy not referred for GERD. Long-segment BE was very uncommon (0.2%) whereas 2.07% of patients not reporting symptoms suffered from silent GERD.
巴雷特食管(BE)是一种与慢性胃食管反流病(GERD)相关的癌前病变。由于只有一小部分BE会发展为恶性肿瘤,因此研究BE的患病率对于预防腺癌很重要。
在2007年1月至2010年12月期间,前瞻性招募了所有接受常规上消化道内镜检查的连续个体。因GERD转诊的患者被排除在研究之外。收集临床和内镜数据。
共纳入1990例患者(平均年龄47.48±13.4岁;52.8%为男性)。其中,496例(24.9%)报告有GERD。221名参与者(11.1%)发现有糜烂性食管炎(EE),193例为洛杉矶分级A级,28例为洛杉矶分级B级。在1494名未报告反流症状的参与者中,共有31例(2.07%)患有无症状GERD。75名参与者(3.77%)被诊断为BE,4例(5.3%)为长段BE,71例(94.7%)为短段BE。1例长段BE患者发现低级别异型增生。196例患者(9.8%)发现有食管裂孔疝(HH),HH平均长度为3.22±0.2cm。BE与EE、GERD和HH的存在相关(p分别为0.0167、<0.001和0.017),而与年龄、饮酒和吸烟无关(p分别为0.057、0.099和0.06)。BE与幽门螺杆菌感染无关(p=0.542)。
在未因GERD转诊而接受上消化道内镜检查的希腊人群中,BE的患病率为3.77%。长段BE非常罕见(0.2%),而2.07%未报告症状的患者患有无症状GERD。