长段巴雷特食管患者的监测：日本一项多中心前瞻性队列研究
Surveillance of patients with long-segment Barrett's esophagus: A multicenter prospective cohort study in Japan.
作者信息
Matsuhashi Nobuyuki, Sakai Eiji, Ohata Ken, Ishimura Norihisa, Fujisaki Junko, Shimizu Tomoki, Iijima Katsunori, Koike Tomoyuki, Endo Takao, Kikuchi Takefumi, Inayoshi Tatsuya, Amano Yuji, Furuta Takahisa, Haruma Ken, Kinoshita Yoshikazu
机构信息
Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan.
Second Department of Internal Medicine, Shimane University School of Medicine, Shimane, Japan.
出版信息
J Gastroenterol Hepatol. 2017 Feb;32(2):409-414. doi: 10.1111/jgh.13491.
BACKGROUND AND AIM
The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively.
METHODS
This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed.
RESULTS
Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection.
CONCLUSIONS
The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.
背景与目的
在日本，长段巴雷特食管（BE）患者中食管腺癌（EAC）的发病率尚未得到研究。本研究的目的是前瞻性地调查日本长段BE患者中EAC的发病率。
方法
这是一项多中心前瞻性队列研究，旨在调查长度至少为3 cm的BE患者中EAC的发病率。研究对象在入组时接受首次食管胃十二指肠镜检查，并被要求每年接受随访食管胃十二指肠镜检查。在内镜检查中被诊断为EAC的患者接受后续治疗，并观察其预后。
结果
在215名入组患者中，有6名（2.8%）在入组时最初被诊断为EAC。在其余209名患者中，132名接受了至少一次随访食管胃十二指肠镜检查。在这次随访中，在251个观察患者年中有3例发生EAC（发病率：每年1.2%）。在首次内镜检查时检测到的大多数EAC（5/6，83%）已经处于晚期。同时，在随访食管胃十二指肠镜检查中检测到的所有3个病变均被鉴定为早期癌症并接受了根治性切除。
结论
日本长段BE患者中EAC的发病率经计算为每年1.2%。
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