DE Carli Diego Michelon, Araujo Amanda Faria de, Fagundes Renato Borges
Serviço de Gastroenterologia, Hospital Universitário, Universidade Federal de Santa Maria, RS, Brazil.
Departamento de Clínica Médica, Universidade Federal de Santa Maria, RS, Brazil.
Arq Gastroenterol. 2017 Dec;54(4):305-307. doi: 10.1590/S0004-2803.201700000-45. Epub 2017 Sep 21.
Barrett's esophagus a complication of gastroesophageal reflux disease (GERD) is a precursor of esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma has been increasing in most Western countries. Rio Grande do Sul (RS), the Southernmost state of Brazil has the highest rates of esophageal cancer with low prevalence of esophageal adenocarcinoma.
To investigate the prevalence of Barrett's esophagus among patients underwent to upper gastrointestinal endoscopy in the last 5 years.
The records of patients underwent upper gastrointestinal endoscopy between 2011 and 2015 were analyzed. Demographic data, GERD symptoms, endoscopic findings, extension and histological diagnosis of columnar epithelia of the esophagus were recorded. Significance among the variables was accessed by chi-square test and Fisher's exact test with 95% CI.
A total of 5996 patients underwent to upper gastrointestinal endoscopy in the period were included. A total of 1769 (30%) patients with GERD symptoms or esophagitis and 107 (1.8%) with columnar lined esophagus were identified. Except for eight patients, the others with columnar lined esophagus had GERD symptoms or esophagitis. Barrett's esophagus defined by the presence of intestinal metaplasia occurred in 47 patients; 20 (43%) with segments over 3 cm and 27 (57%) with segments shorter than 3 cm. The global prevalence of Barrett's esophagus was 0.7% and in GERD patients 2.7%. The odds ratio for the occurrence of columnar lined esophagus in patients with GERD was 30 (95%CI=15.37-63.34). The odds ratio for the presence of intestinal metaplasia in long segments was 8 (95%CI=2.83-23.21).
GERD patients had a risk 30-folds greater to present columnar lined esophagus than patients without GERD symptoms. Long segments of columnar lined esophagus, had a risk eight-folds higher to have Barrett's esophagus than short segments. Barrett's esophagus overall prevalence was 0.7%. In GERD patients, the prevalence was 2.7%. Long Barrett's esophagus represented globally 0.3% and 1.1% in GERD patients.
巴雷特食管是胃食管反流病（GERD）的一种并发症，是食管腺癌的癌前病变。在大多数西方国家，食管腺癌的发病率一直在上升。巴西南部的南里奥格兰德州（RS）食管癌发病率最高，但食管腺癌患病率较低。
调查过去5年接受上消化道内镜检查的患者中巴雷特食管的患病率。
分析2011年至2015年间接受上消化道内镜检查的患者记录。记录人口统计学数据、GERD症状、内镜检查结果、食管柱状上皮的范围和组织学诊断。通过卡方检验和95%置信区间的费舍尔精确检验评估变量之间的显著性。
该时期共有5996例患者接受了上消化道内镜检查。共识别出1769例（30%）有GERD症状或食管炎的患者和107例（1.8%）有食管柱状上皮化生的患者。除8例患者外，其他有食管柱状上皮化生的患者均有GERD症状或食管炎。由肠化生的存在定义的巴雷特食管发生在47例患者中；20例（43%）节段超过3 cm，27例（57%）节段短于3 cm。巴雷特食管的总体患病率为0.7%，在GERD患者中为2.7%。GERD患者发生食管柱状上皮化生的比值比为30（95%CI=15.37-63.34）。长节段肠化生存在的比值比为8（95%CI=2.83-23.21）。
与无GERD症状的患者相比，GERD患者出现食管柱状上皮化生的风险高30倍。长节段的食管柱状上皮化生发生巴雷特食管的风险比短节段高8倍。巴雷特食管的总体患病率为0.7%。在GERD患者中，患病率为2.7%。长节段巴雷特食管在全球范围内占0.3%，在GERD患者中占1.1%。
