Antonios Kais, Aintabi Daniel, McNally Patricia, Berinstein Elliot, Dutta Priyata, Sampson Nicholas, Wang Sichao, Carrillo Claudia Villarreal, Singh Brahm, Haider Marjan, Shellenberger Richard A
Trinity Health Ann Arbor Hospital, Ann Arbor, Michigan, USA.
Internal Medicine, Trinity Health Ann Arbor Hospital, Ypsilanti, Michigan, USA.
Cancer Rep (Hoboken). 2025 Mar;8(3):e70168. doi: 10.1002/cnr2.70168.
Barrett's esophagus (BE) is the most widely established precursor to esophageal adenocarcinoma (EAC). Despite current screening guidelines, more than 90% of EAC patients lack a previous diagnosis of BE. We performed a systematic review and meta-analysis to identify the most important risk factors for the development of BE or EAC.
PubMed.gov, Ovid Medline, Embase, and Cochrane Library were searched through March 15, 2024. Studies comparing characteristics of patients with endoscopically diagnosed BE or EAC to control groups satisfied our inclusion criteria. Dual extraction provided data for random-effects meta-analyses. Sufficient data were extracted from 54 included studies to perform our meta-analyses. There were five risk factors with significant associations for the development of BE: symptoms of gastroesophageal reflux at least once weekly (OR, 3.56; 95% confidence interval [CI], 2.03-6.25; p = 0.004) tobacco smoking (OR, 1.41; 95% CI, 1.30-1.51; p < 0.001); alcohol use (OR, 1.37; 95% CI, 1.10-1.71; p = 0.008); male gender (OR, 1.36; 95% CI, 1.19-1.57; p < 0.001); and obesity (BMI > 30 kg/m) (OR, 1.23; 95% CI, 1.09-1.39; p = 0.003). Tobacco smoking was significantly associated with the diagnosis of EAC (OR, 2.15; 95% CI, 1.85-2.43; p < 0.001).
Five risk factors showed significant associations with the development of BE and one with the development of EAC, with over a three-fold increase in BE for patients with gastroesophageal reflux more than once weekly. These data could prove useful in developing diagnostic paradigms with higher emphasis on patients experiencing more frequent acid reflux.
巴雷特食管（BE）是食管腺癌（EAC）最广泛认可的癌前病变。尽管有当前的筛查指南，但超过90%的EAC患者之前未被诊断出患有BE。我们进行了一项系统综述和荟萃分析，以确定BE或EAC发生的最重要风险因素。
检索了截至2024年3月15日的PubMed.gov、Ovid Medline、Embase和Cochrane图书馆。将经内镜诊断为BE或EAC的患者与对照组的特征进行比较的研究符合我们的纳入标准。双人提取为随机效应荟萃分析提供数据。从54项纳入研究中提取了足够的数据来进行我们的荟萃分析。有五个风险因素与BE的发生有显著关联：每周至少出现一次胃食管反流症状（比值比[OR]，3.56；95%置信区间[CI]，2.03 - 6.25；p = 0.004）；吸烟（OR，1.41；95% CI，1.30 - 1.51；p < 0.001）；饮酒（OR，1.37；95% CI，1.10 - 1.71；p = 0.008）；男性（OR，1.36；95% CI，1.19 - 1.57；p < 0.001）；肥胖（体重指数[BMI] > 30 kg/m²）（OR，1.23；95% CI，1.09 - 1.39；p = 0.003）。吸烟与EAC的诊断显著相关（OR，2.15；95% CI，1.85 - 2.43；p < 0.001）。
五个风险因素与BE的发生显著相关，一个与EAC的发生相关，每周出现多次胃食管反流的患者患BE的风险增加三倍以上。这些数据可能有助于制定更侧重于频繁发生胃酸反流患者的诊断模式。
