Navab Farhad, Nathanson Brian H, Desilets David J
Baystate Health, Springfield, MA, USA; Tufts University School of Medicine, Boston, MA, USA.
OptiStatim, LLC, Longmeadow MA, USA.
Cancer Epidemiol. 2015 Dec;39(6):885-91. doi: 10.1016/j.canep.2015.10.013. Epub 2015 Nov 9.
Barrett's Esophagus (BE), particularly long-segment Barrett's Esophagus, and the age of onset of Barrett's Esophagus are risk factors for esophageal adenocarcinoma. However, it is unknown if lifestyle factors such as alcohol abuse, tobacco use, weight gains that increase the risk of developing BE and esophageal adenocarcinoma affect its length or age at diagnosis.
In a retrospective, cross-sectional analysis, we analyzed 158 newly diagnosed adult BE patients at a 600-bed tertiary care center in the United States from 1999 to 2008. We constructed generalized linear models for the outcomes of BE length and age at diagnosis. Predictors of interest included current or prior alcohol abuse, tobacco use, weight gain over the last 5 years, and body mass index (BMI).
71 (45%) had length ≥ 3 cm. Barrett's Esophagus length was positively correlated with hiatal hernia length (r=0.67, p<0.001) and heartburn duration (r=0.36, p<0.001). Multivariate results showed no significant relationship between alcohol abuse, tobacco use, weight gain or BMI and BE length. Patients with weight gain, current tobacco use, and male gender were diagnosed at a significantly younger age than their peers (for example, the adjusted mean age at diagnosis for current tobacco users vs. non-smokers was 49.2 years vs. 54.7 years, p=0.029).
Lifestyle factors did not appear to affect Barrett's Esophagus length but weight gains, smoking, and male gender were associated with a diagnosis at a significantly younger age.
巴雷特食管（BE），尤其是长段巴雷特食管，以及巴雷特食管的发病年龄是食管腺癌的危险因素。然而，诸如酗酒、吸烟、体重增加等增加患BE和食管腺癌风险的生活方式因素是否会影响其诊断时的长度或年龄尚不清楚。
在一项回顾性横断面分析中，我们分析了1999年至2008年在美国一家拥有600张床位的三级医疗中心新诊断的158例成年BE患者。我们构建了关于BE长度和诊断年龄结果的广义线性模型。感兴趣的预测因素包括当前或既往酗酒、吸烟、过去5年的体重增加以及体重指数（BMI）。
71例（45%）的长度≥3 cm。巴雷特食管长度与食管裂孔疝长度呈正相关（r = 0.67，p < 0.001），与烧心持续时间呈正相关（r = 0.36，p < 0.001）。多变量结果显示，酗酒、吸烟、体重增加或BMI与BE长度之间无显著关系。体重增加、当前吸烟的患者以及男性被诊断时的年龄明显低于同龄人（例如，当前吸烟者与非吸烟者诊断时的调整后平均年龄分别为49.2岁和54.7岁，p = 0.029）。
生活方式因素似乎不影响巴雷特食管长度，但体重增加、吸烟和男性与诊断时年龄明显较小有关。
