Health Center, Shimane Environment and Health Public Corporation, Japan.
Second Department of Internal Medicine, Shimane University Faculty of Medicine, Japan.
Intern Med. 2021 Mar 1;60(5):667-674. doi: 10.2169/internalmedicine.5676-20. Epub 2020 Sep 30.
Objective This study was conducted to clarify the prevalence of short segment Barrett's esophagus (SSBE) using endoscopic observations with linked color imaging (LCI). In addition, the relationship between the presence of Barrett's epithelium (BE) and the status of H. pylori infection was investigated. Methods The study subjects were 3,353 individuals (2,186 men, 1,167 women; mean age 55.2±9.4 years old) whose status of H. pylori infection had been determined. An endoscopic observation using LCI was performed to examine the distal margin of palisade vessels and confirm the area of BE. The prevalence of BE ≥5 mm in length was investigated. Results BE was diagnosed in 1,884 (56.2%) subjects, with lengths of <10, 10-19, 20-29, and ≥30 mm found in 1,005, 851, 27, and 1, respectively. Its prevalence in H. pylori-negative, H. pylori-positive, and post-eradicated subjects was 41.7%, 64.4%, and 69.9%, respectively (p<0.001). The duration since successful eradication of H. pylori did not affect the prevalence of BE. The degree of gastric mucosal atrophy was higher in cases with BE (p<0.001), although negativity for H. pylori infection and mild gastric mucosal atrophy were significant factors for the development of longer BE. Conclusion A high prevalence of SSBE was noted when LCI was used to determine the area of BE, as the distal end of the palisade vessels was easily visualized. Negativity for H. pylori infection and mild gastric mucosal atrophy were not correlated with SSBE prevalence.
目的 本研究旨在通过内镜下观察并结合显色内镜(LCI)明确短节段 Barrett 食管(SSBE)的流行情况。此外,还调查了 Barrett 上皮(BE)的存在与 H. pylori 感染状况之间的关系。
方法 本研究对象为 3353 名个体(2186 名男性,1167 名女性;平均年龄 55.2±9.4 岁),其 H. pylori 感染状况已确定。进行 LCI 内镜观察以检查栅状血管的远端边缘并确认 BE 区域。调查 BE 长度≥5mm 的患病率。
结果 在 1884 名(56.2%)受试者中诊断出 BE,长度<10、10-19、20-29 和≥30mm 的分别为 1005、851、27 和 1 例。H. pylori 阴性、H. pylori 阳性和 H. pylori 根除后患者的 BE 患病率分别为 41.7%、64.4%和 69.9%(p<0.001)。H. pylori 根除成功后的时间长短并不影响 BE 的患病率。有 BE 患者的胃黏膜萎缩程度更高(p<0.001),尽管 H. pylori 感染阴性和轻度胃黏膜萎缩是 BE 长度较长的重要因素。
结论 当使用 LCI 确定 BE 区域时,注意到 SSBE 的高患病率,因为栅状血管的远端很容易可视化。H. pylori 感染阴性和轻度胃黏膜萎缩与 SSBE 患病率无关。