Chen Songfeng, Xiang Xuelian, Zhang Xiaohao, Zhuang Qianjun, Tan Niandi, Hou Xun, Zhang Mengyu, Hu Junnan, Duan Chaofan, Cui Yi, Wang Jinhui, Xing Xiangbin, Zhang Nina, Xiao Yinglian
Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China.
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.
Gastroenterol Rep (Oxf). 2022 Oct 13;10:goac057. doi: 10.1093/gastro/goac057. eCollection 2022.
Asymptomatic low-grade (Los Angeles Classification Grades A and B) esophagitis is common in clinical practice with unclear clinical outcomes. This study aimed to explore the clinical outcomes of asymptomatic low-grade esophagitis.
This was a multicenter cohort study conducted by three academic hospitals in China. Asymptomatic low-grade esophagitis patients between January 2015 and December 2019 were included. Mucosal healing condition 1 year after initial diagnosis, symptom outcomes, and proton-pump inhibitor (PPI) use within 1 year after initial diagnosis were studied and compared.
A total of 248 asymptomatic low-grade esophagitis patients were included. Esophagitis disappeared in 76.2% of patients 1 year after initial diagnosis. In terms of symptom outcomes, 89.9% of patients did not present gastroesophageal reflux disease (GERD) symptoms within 1 year after initial diagnosis. No significant difference was found in the proportion of patients who presented GERD symptoms and in the proportion of patients with persistent esophagitis between the PPI group and the non-PPI group (all >0.05). Patients with initial Grade B esophagitis were more likely to present follow-up GERD symptoms (16.0% vs 7.5%, =0.041) and had more severe follow-up esophagitis than those with Grade A (<0.001). Patients with follow-up GERD symptoms were more likely to have persistent esophagitis than those without.
This study demonstrated that asymptomatic low-grade esophagitis had relatively benign clinical outcomes. Patients with initial Grade B esophagitis and patients with follow-up GERD symptoms were more likely to be those who are in genuine need of further follow-up and treatments.
无症状性轻度（洛杉矶分类法A和B级）食管炎在临床实践中很常见，但其临床结局尚不清楚。本研究旨在探讨无症状性轻度食管炎的临床结局。
这是一项由中国三家学术医院开展的多中心队列研究。纳入2015年1月至2019年12月期间的无症状性轻度食管炎患者。研究并比较初次诊断后1年的黏膜愈合情况、症状结局以及初次诊断后1年内质子泵抑制剂（PPI）的使用情况。
共纳入248例无症状性轻度食管炎患者。初次诊断后1年，76.2%的患者食管炎消失。在症状结局方面，89.9%的患者在初次诊断后1年内未出现胃食管反流病（GERD）症状。PPI组和非PPI组出现GERD症状的患者比例以及持续性食管炎患者比例差异均无统计学意义（均>0.05）。初次诊断为B级食管炎的患者更易出现随访GERD症状（16.0%对7.5%，P=0.041），且随访食管炎比A级患者更严重（P<0.001）。有随访GERD症状的患者比无该症状的患者更易出现持续性食管炎。
本研究表明，无症状性轻度食管炎具有相对良好的临床结局。初次诊断为B级食管炎的患者以及有随访GERD症状的患者更有可能是真正需要进一步随访和治疗的人群。
