Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China.
Chin Med J (Engl). 2019 Jul 5;132(13):1516-1523. doi: 10.1097/CM9.0000000000000275.
The exact relationship between gastroesophageal reflux disease (GERD) and esophageal squamous cell cancer (ESCC) is far from clarification. The aim of this study was to investigate the epidemiology of GERD in a region with high prevalence of ESCC in China.
A population-based, cross-sectional study was conducted in a high ESCC prevalent area, Anyang, Henan, China. All subjects fulfilled questionnaires and underwent gastroendoscopy with routine esophageal biopsy. The subjects were divided into GERD subtypes (reflux esophagitis [RE] and non-erosive reflux disease [NERD]) and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine risk factors for RE and NERD.
A total of 2844 subjects were finally enrolled. The prevalence of GERD (RE + NERD) was 17.3%. Among them, 271 (9.53%) adults were diagnosed with RE. The prevalence of RE increased with age (7.09% in 45-50 years, 8.00% in 51-60 years, and 9.53% in 61-69 years, χ = 62.216, P < 0.001). Sixty-seven (2.36%) subjects were diagnosed with the silent RE. A total of 221 (7.77%) subjects were diagnosed with NERD. Frequent liquid food consumption (OR [95% CI]: 1.502 [1.076-2.095]) was independent risk factor for RE as well as age, male gender, high body mass index (BMI), ever smoking. Age was independent risk factor for NERD. For silent RE, age, male gender, and frequent liquid food consumption were risk factors.
In the population with high prevalence of ESCC, a high prevalence of GERD and inverted proportion of RE/NERD were presented. Age was an independent risk factor for GERD. The male gender, high BMI, smoking, and frequent liquid food consumption may be risk factors for RE but not for NERD.
胃食管反流病（GERD）和食管鳞状细胞癌（ESCC）之间的确切关系尚不清楚。本研究旨在探讨中国 ESCC 高发地区 GERD 的流行病学。
在河南省安阳市这一 ESCC 高发地区进行了一项基于人群的横断面研究。所有研究对象均完成了问卷调查，并接受了常规食管活检的胃镜检查。研究对象分为 GERD 亚型（反流性食管炎[RE]和非糜烂性反流病[NED]）和对照组。计算比值比（OR）和 95%置信区间（CI）以检查 RE 和 NED 的危险因素。
共纳入 2844 名研究对象，GERD（RE+NERD）的患病率为 17.3%。其中，271 名（9.53%）成年人被诊断为 RE。RE 的患病率随年龄增长而增加（45-50 岁为 7.09%，51-60 岁为 8.00%，61-69 岁为 9.53%，χ²=62.216，P<0.001）。67 名（2.36%）患者被诊断为无症状性 RE。221 名（7.77%）患者被诊断为 NERD。经常食用液体食物（OR[95%CI]：1.502[1.076-2.095]）是 RE 的独立危险因素，也是年龄、男性、高体重指数（BMI）、吸烟史的独立危险因素。年龄是 NERD 的独立危险因素。对于无症状性 RE，年龄、男性和经常食用液体食物是危险因素。
在 ESCC 高发人群中，GERD 患病率较高，RE/NERD 比例倒置。年龄是 GERD 的独立危险因素。男性、高 BMI、吸烟和经常食用液体食物可能是 RE 的危险因素，但不是 NERD 的危险因素。
