Department of Gastroenterology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, China.
Department of Gastroenterology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China.
J Cancer Res Clin Oncol. 2023 Sep;149(11):8327-8334. doi: 10.1007/s00432-023-04772-5. Epub 2023 Apr 19.
Studies have demonstrated that non-acid reflux (NAR) is associated with esophageal squamous cell carcinoma (ESCC). Esophageal dysmotility is associated with NAR but few studies have focused on the esophageal motility of ESCC patients. We explored the relationship between ESCC, NAR and esophageal dysmotility with the aid of multichannel intraluminal impedance and pH (MII-pH) and high-resolution manometry (HRM).
From Jan 2021 to Oct 2022, 20 patients with superficial ESCC were enrolled as the ESCC group, while 20 age and gender matched individuals without gastroesophageal reflux disease (GERD) symptoms and 20 age and gender matched patients with GERD symptoms were recruited as the control groups. Patients received 24 h MII-pH and HRM procedure before endoscopic submucosal dissection (ESD), and the data were then collected to identify the type of reflux and esophageal dysmotility.
Prevalence of esophageal dysmotility was significantly different among the three groups, 75.0% in the ESCC group, 35.0% in the non-GERD group and 70.0% in the GERD group (P = 0.029). NAR episodes at 15 cm above the lower esophageal sphincter (LES) in the ESCC group were significantly higher than that in the non-GERD group (6.5 (3.5-9.3) vs 1.0 (0.8-4.0), P = 0.001) and were similar with that in the GERD group (6.5 (3.5-9.3) vs 5.5 (3.0-10.5), P > 0.05). NAR episodes at 5 cm above LES was significantly higher in the ESCC group than that in the non-GERD group (38.0 (27.0-60.0) vs 18.0 (11.8-25.8), P = 0.001) and was significantly higher than that in the GERD group (38.0 (27.0-60.0) vs 20.0 (9.8-30.5)), P = 0.010). Prevalence of pathologic non-acid reflux was significantly different among the three groups, 30.0% in the ESCC group, 0.0% in the non-GERD group and 10.0% in the GERD group (P < 0.001).
Our study found NAR and esophageal dysfunction frequently occur in ESCC patients. NAR and esophageal dysmotility may be associated with ESCC.
ChiCTR2200061456.
研究表明，非酸性反流（NAR）与食管鳞状细胞癌（ESCC）有关。食管动力障碍与 NAR 有关，但很少有研究关注 ESCC 患者的食管动力。我们借助多通道腔内阻抗和 pH（MII-pH）及高分辨率测压（HRM）来探讨 ESCC、NAR 和食管动力障碍之间的关系。
2021 年 1 月至 2022 年 10 月，纳入 20 例浅表性 ESCC 患者作为 ESCC 组，同时纳入 20 例年龄和性别相匹配、无胃食管反流病（GERD）症状的个体和 20 例年龄和性别相匹配、有 GERD 症状的患者作为对照组。所有患者在接受内镜黏膜下剥离术（ESD）前均接受 24 h MII-pH 和 HRM 检查，并收集数据以确定反流类型和食管动力障碍。
三组之间食管动力障碍的发生率差异有统计学意义，ESCC 组为 75.0%，非 GERD 组为 35.0%，GERD 组为 70.0%（P=0.029）。ESCC 组食管下括约肌（LES）上方 15 cm 处的 NAR 发作次数明显高于非 GERD 组（6.5（3.5-9.3）比 1.0（0.8-4.0），P=0.001），与 GERD 组相似（6.5（3.5-9.3）比 5.5（3.0-10.5），P>0.05）。ESCC 组 LES 上方 5 cm 处的 NAR 发作次数明显高于非 GERD 组（38.0（27.0-60.0）比 18.0（11.8-25.8），P=0.001），明显高于 GERD 组（38.0（27.0-60.0）比 20.0（9.8-30.5），P=0.010）。三组之间病理性非酸性反流的发生率差异有统计学意义，ESCC 组为 30.0%，非 GERD 组为 0.0%，GERD 组为 10.0%（P<0.001）。
本研究发现 NAR 和食管功能障碍在 ESCC 患者中经常发生。NAR 和食管动力障碍可能与 ESCC 有关。
ChiCTR2200061456。
