Zagari Rocco Maurizio, Eusebi Leonardo Henry, Rabitti Stefano, Cristoferi Laura, Vestito Amanda, Pagano Nico, Bazzoli Franco
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Gastroenterology Unit, S.Orsola-Malpighi Hospital, Bologna, Italy.
J Gastroenterol Hepatol. 2016 Sep;31(9):1527-38. doi: 10.1111/jgh.13308.
Upper gastrointestinal endoscopic findings, such as esophagitis, Barrett's esophagus, peptic ulcer, and malignancy, represent a public health problem. This systematic review aimed to evaluate the prevalence of upper gastrointestinal endoscopic findings in the community.
A systematic search was conducted in PUBMED and EMBASE to May 2015. Studies were eligible if they reported the prevalence of upper gastrointestinal endoscopic findings in unselected samples of the community.
Twelve articles were eligible, nine reported data from three endoscopic surveys (n = 3063 subjects), and three from national screening programs (n = 84 153). The overall prevalence of upper gastrointestinal endoscopic findings in the community was 30% in the Kalixanda study (Sweden), 24.9% in the Loiano-Monghidoro study (Italy), and 68.9% in the Systematic Investigation of Gastrointestinal Diseases study (China). The pooled prevalence of esophagitis, endoscopically suspected esophageal metaplasia (ESEM), peptic ulcer, and gastric cancer in all studies was 11.2, 5.1, 6.8, and 0.33%, respectively. The most frequent finding was esophagitis in Europe, with a prevalence of 15.5% in Sweden and 11.8% in Italy, and peptic ulcer in China (17.1%), both in asymptomatic and symptomatic individuals. The prevalence of Helicobacter pylori was positively associated with the prevalence of peptic ulcer (r = 0.91) but negatively associated with the prevalence of both esophagitis (r = -0.99) and ESEM (r = -0.95).
Upper gastrointestinal endoscopic findings are present in at least a quarter of subjects in the community with different patterns in Western and Eastern countries, both in asymptomatic and symptomatic subjects. H. pylori prevalence negatively impacts on the prevalence of reflux-related esophageal findings.
上消化道内镜检查结果，如食管炎、巴雷特食管、消化性溃疡和恶性肿瘤，是一个公共卫生问题。本系统评价旨在评估社区中上消化道内镜检查结果的患病率。
截至2015年5月，在PUBMED和EMBASE中进行了系统检索。如果研究报告了社区未选择样本中上消化道内镜检查结果的患病率，则该研究符合纳入标准。
12篇文章符合纳入标准，9篇报告了来自三项内镜调查的数据（n = 3063名受试者），3篇来自国家筛查项目（n = 84153）。在卡里克斯兰达研究（瑞典）中，社区中上消化道内镜检查结果的总体患病率为30%，在洛亚诺 - 蒙吉多罗研究（意大利）中为24.9%，在胃肠疾病系统调查研究（中国）中为68.9%。在所有研究中，食管炎、内镜疑似食管化生（ESEM）、消化性溃疡和胃癌的合并患病率分别为11.2%、5.1%、6.8%和0.33%。最常见的发现是欧洲的食管炎，瑞典患病率为15.5%，意大利为11.8%，中国的消化性溃疡患病率（17.1%）最高，无论有无症状个体均如此。幽门螺杆菌的患病率与消化性溃疡的患病率呈正相关（r = 0.91），但与食管炎（r = -0.99）和ESEM（r = -0.95）的患病率呈负相关。
在社区中，至少四分之一的受试者存在上消化道内镜检查结果，东西方国家存在不同模式，无论有无症状。幽门螺杆菌患病率对反流相关食管病变的患病率有负面影响。
