Thota Prashanthi N, Zackria Shamiq, Sanaka Madhusudhan R, Patil Deepa, Goldblum John, Lopez Rocio, Chak Amitabh
Departments of *Gastroenterology and Hepatology †Pathology ‡Biostatistics, Cleveland Clinic §Department of Gastroenterology, University Hospitals, Cleveland, OH.
J Clin Gastroenterol. 2017 May/Jun;51(5):402-406. doi: 10.1097/MCG.0000000000000559.
Our aim was to study the prevalence of dysplasia and progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in African Americans (AA) with Barrett's esophagus (BE) and compare it with that of non-Hispanic white (NHW) controls.
BE, a precursor of EAC, is a disease of predominantly white men and is uncommon in AA. The prevalence of dysplasia and progression to HGD and EAC in AA patients with BE is not clearly known.
All AA or NHW patients with confirmed BE, that is specialized intestinal metaplasia, seen between 2002 and 2013 at our institution were included. Variables such as age, gender, medication use, the body mass index, the date of endoscopy, the hiatal hernia size, the BE length, and histologic findings were noted. Progression to HGD/EAC was evaluated.
Fifty-two AA and 2394 NHW patients with BE were identified. There was a higher percentage of women in the AA cohort (46.2%) than in the NHW cohort (24.9%, P<0.001). Nondysplastic BE was more prevalent in AA than in NHW (80.8% vs. 68.4%, P=0.058). In the surveillance cohort of 20 AA and 991 NHW, no racial differences in progression to HGD/EAC were observed during a median follow-up of 43 months.
This study includes the largest number of AA with histologically confirmed BE reported so far. About 46.2% of the AA cohort with BE in our study consisted of women. There was a trend toward a higher prevalence of nondysplastic BE in AA compared with NHW.
我们的目的是研究患有巴雷特食管（BE）的非裔美国人（AA）中发育异常以及进展为高级别发育异常（HGD）和食管腺癌（EAC）的患病率，并将其与非西班牙裔白人（NHW）对照组进行比较。
BE是EAC的前驱疾病，主要见于白人男性，在AA中并不常见。患有BE的AA患者中发育异常以及进展为HGD和EAC的患病率尚不清楚。
纳入了2002年至2013年间在我们机构就诊的所有经确诊为BE（即特殊肠化生）的AA或NHW患者。记录了年龄、性别、用药情况、体重指数、内镜检查日期、食管裂孔疝大小、BE长度和组织学检查结果等变量。评估进展为HGD/EAC的情况。
共识别出52例患有BE的AA患者和2394例患有BE的NHW患者。AA队列中的女性比例（46.2%）高于NHW队列（24.9%，P<0.001）。非发育异常性BE在AA中比在NHW中更常见（80.8%对68.4%，P=0.058）。在20例AA和991例NHW的监测队列中，在中位随访43个月期间，未观察到进展为HGD/EAC的种族差异。
本研究纳入了迄今为止报告的组织学确诊BE的AA患者数量最多。在我们的研究中，约46.2%的患有BE的AA队列由女性组成。与NHW相比，AA中非发育异常性BE的患病率有更高的趋势。
