Chisholm Sian S, Khoury Joe E, Jamal M Mazen, Palacio Carlos, Pudhota Sunitha, Vega Kenneth J
Department of Medicine, University of Florida/Jacksonville, Jacksonville, FL, USA.
Division of Gastroenterology, University of Florida/Jacksonville, Jacksonville, FL, USA.
J Gastrointest Oncol. 2017 Feb;8(1):102-108. doi: 10.21037/jgo.2016.12.07.
Barrett's esophagus (BE) is the primary risk factor for esophageal adenocarcinoma (EAC). Limited data exists regarding the frequency of histologically confirmed BE by both gender and ethnicity in the United States. The study aim was to determine whether the frequency of histologically confirmed BE varies by ethnicity and gender.
The University of Florida-Jacksonville endoscopy database was reviewed for all cases of salmon colored esophageal mucosa from September 2002 to August 2007. Histologic BE was diagnosed only if salmon colored esophageal mucosa was seen endoscopically and biopsy confirmed intestinal metaplasia with goblet cells. Data collected included: age at diagnosis, self-reported ethnicity [non-Hispanic white (nHw) or African American (AA)], gender, procedure indication, gastroesophageal reflux disease (GERD) history, atypical manifestations, cigarette smoking, alcohol use, proton pump inhibitor (PPI) use, BE endoscopic length, absence/presence of hiatal hernia, stricture or ulcer, and absence/presence/grade of dysplasia.
Salmon colored esophageal mucosa was identified in 391/7,308 patients, distributed ethnically as 306 nHw and 85 AA. Histologic BE was confirmed in 111/391 patients with ethnic distribution of: 95 nHw and 16 AA. Histologically confirmed BE frequency varied both by gender and ethnicity with nHw males having the highest (42.3%) and AA females the lowest (12.3%). Histologically confirmed BE frequency differed significantly between nHw males and nHw/AA females only (P<0.005).
Histologically confirmed BE frequency varies by ethnicity and gender with nHw males having the highest frequency/risk and AA females the lowest. Investigation to improve understanding of the impact of race and gender in BE formation should be performed.
巴雷特食管(BE)是食管腺癌(EAC)的主要危险因素。在美国,关于按性别和种族划分的经组织学证实的BE发生率的数据有限。本研究的目的是确定经组织学证实的BE发生率是否因种族和性别而异。
回顾了佛罗里达大学杰克逊维尔分校2002年9月至2007年8月间所有出现鲑鱼色食管黏膜病例的内镜检查数据库。仅当在内镜检查中看到鲑鱼色食管黏膜且活检证实为含有杯状细胞的肠化生时,才诊断为组织学BE。收集的数据包括:诊断时的年龄、自我报告的种族[非西班牙裔白人(nHw)或非裔美国人(AA)]、性别、手术指征、胃食管反流病(GERD)病史、非典型表现、吸烟、饮酒、质子泵抑制剂(PPI)使用情况、BE的内镜长度、是否存在食管裂孔疝、狭窄或溃疡,以及是否存在发育异常/发育异常的分级。
在7308例患者中,有391例发现了鲑鱼色食管黏膜,按种族分布为306例nHw和85例AA。在391例患者中,有111例经组织学证实为BE,种族分布为:95例nHw和l6例AA。经组织学证实的BE发生率因性别和种族而异,nHw男性最高(42.3%),AA女性最低(12.3%)。仅nHw男性与nHw/AA女性之间经组织学证实的BE发生率存在显著差异(P<0.005)。
经组织学证实的BE发生率因种族和性别而异,nHw男性发生率/风险最高,AA女性最低。应开展研究以增进对种族和性别在BE形成中影响的理解。