Tanaka Ippei, Unno Shuhei, Yamamoto Kazuki, Nawata Yoshitaka, Igarashi Kimihiro, Matsuda Tomoki, Hirasawa Dai
Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan.
Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
Clin Endosc. 2025 Jan;58(1):85-93. doi: 10.5946/ce.2024.068. Epub 2024 Nov 11.
BACKGROUND/AIMS: We aimed to clarify the clinicopathological characteristics and causes of Barrett's esophageal adenocarcinoma (BEA) with unclear demarcation.
We reviewed BEA cases between January 2010 and August 2022. The lesions were classified into the following two groups: clear demarcation (CD group) and unclear demarcation (UD group). We compared the clinicopathological findings between the two groups. Furthermore, we measured the length and width of the foveolar structures, as well as the width of marginal crypt epithelium (MCE).
We analyzed data from 68 patients with BEA, including 47 and 21 in the CD and UD groups, respectively. Multivariate analysis revealed long-segment Barrett's esophagus (LSBE) as the sole significant risk factor for BEA (odds ratio, 12.17; 95% confidence interval, 2.84-47.6; p=0.001). Regarding pathological analysis, significant differences were observed in the length and width of the foveolar structure between cancerous and surrounding mucosa in the CD group (p=0.03 and p=0.00, respectively); however, no significant difference was observed in the UD group (p=0.53 and p=0.72, respectively). Nevertheless, the width of MCE in the cancerous area was significantly shorter than that in the surrounding mucosa in both groups (p<0.05, and p<0.05, respectively).
LSBE is a significant risk factor for BEA in the UD group. The width of MCE may be an important factor in the endoscopic diagnosis of BEA.
背景/目的：我们旨在阐明边界不清晰的巴雷特食管腺癌（BEA）的临床病理特征及病因。
我们回顾了2010年1月至2022年8月期间的BEA病例。病变分为以下两组：边界清晰组（CD组）和边界不清晰组（UD组）。我们比较了两组的临床病理结果。此外，我们测量了腺管结构的长度和宽度，以及边缘隐窝上皮（MCE）的宽度。
我们分析了68例BEA患者的数据，其中CD组47例，UD组21例。多因素分析显示长段巴雷特食管（LSBE）是BEA的唯一显著危险因素（比值比，12.17；95%置信区间，2.84 - 47.6；p = 0.001）。关于病理分析，CD组癌组织与周围黏膜的腺管结构长度和宽度存在显著差异（分别为p = 0.03和p = 0.00）；然而，UD组未观察到显著差异（分别为p = 0.53和p = 0.72）。尽管如此，两组癌组织区域的MCE宽度均显著短于周围黏膜（分别为p < 0.05和p < 0.05）。
LSBE是UD组BEA的显著危险因素。MCE宽度可能是BEA内镜诊断的一个重要因素。
