Degiovani Matheus, Ribas Carmem Australia Paredes Marcondes, Czeczko Nicolau Gregori, Parada Artur Adolfo, Fronchetti Juliana de Andrade, Malafaia Osvaldo
Postgraduate Program in Principles of Surgery, Mackenzie Evangelical School of Medicine - Paraná, Curitiba, PR, Brazil.
Digestive Endoscopy Service, 9 de Julho Hospital, São Paulo, SP, Brazil.
Arq Bras Cir Dig. 2019 Dec 20;32(4):e1480. doi: 10.1590/0102-672020190001e1480. eCollection 2019.
The presence of intestinal metaplasia in the distal esophagus (Barrett's esophagus) is an important precursor of adenocarcinoma. Knowledge of the risk factors and the process by which the Barrett develops is very important and Helicobacter pylori (HP) can contribute to this development.
To analyze the impact of HP in the gastric mucosa with intestinal metaplasia in the distal esophagus in areas of columnar epithelialization smaller than 10 mm in length and epidemiological data on prevalence.
A retrospective study in which were included 373 consecutive patients diagnosed with columnar epithelium in the distal esophagus was done. In all, HP was investigated by urease and histology, exclusion and inclusion factors were applied and patients were divided into two groups: the first grouping the ones without histological diagnosis of Barrett's esophagus (235-63%) and the second with it (138-37%).
There was no significant difference between HP and non-HP patients in relation to the probability of having intestinal metaplasia (p=0.587). When related to the general group, there was an inverse association between the bacterium and the columnar epithelia in the distal esophagus. Age (p=0.031), gender (p=0.013) and HP (p=0.613) when related together to intestinal metaplasia showed no significant relation. In isolation, when related to age and gender, regardless of HP, results confirmed that patients in more advanced age and women present a higher incidence of intestinal metaplasia.
There is an inverse relation between HP and the areas of columnar epithelization in the distal esophagus, regardless of the presence or absence of intestinal metaplasia. Age and gender, regardless of HP, showed higher prevalence in women and in older the number of cases with intestinal metaplasia in the distal esophagus.
远端食管肠化生(巴雷特食管)的存在是腺癌的重要前驱病变。了解危险因素以及巴雷特食管的发展过程非常重要,幽门螺杆菌(HP)可能参与这一发展过程。
分析HP对远端食管柱状上皮化生长度小于10mm区域的胃黏膜的影响以及患病率的流行病学数据。
进行一项回顾性研究,纳入373例连续诊断为远端食管柱状上皮的患者。总体上,通过尿素酶和组织学检测HP,应用排除和纳入因素,将患者分为两组:第一组为无巴雷特食管组织学诊断的患者(235例,占63%),第二组为有巴雷特食管组织学诊断的患者(138例,占37%)。
HP阳性和阴性患者在发生肠化生的概率方面无显著差异(p = 0.587)。与总体组相关时,该细菌与远端食管柱状上皮之间存在负相关。年龄(p = 0.031)、性别(p = 0.013)和HP(p = 0.613)与肠化生相关时无显著关系。单独来看,与年龄和性别相关时,无论HP情况如何,结果证实年龄较大的患者和女性肠化生的发生率较高。
无论是否存在肠化生,HP与远端食管柱状上皮区域之间存在负相关。无论HP情况如何,年龄和性别方面,女性以及年龄较大者远端食管肠化生的病例数患病率较高。