Eisen G M, Sandler R S, Murray S, Gottfried M
University of North Carolina at Chapel Hill, USA.
Am J Gastroenterol. 1997 Jan;92(1):27-31.
Barrett's esophagus is a condition in which the stratified squamous epithelium of the esophagus is replaced by a columnar epithelium with malignant potential. Chronic gastroesophageal reflux disease (GERD) is accepted as the primary risk factor for the development of Barrett's esophagus, but only a small fraction of individuals with GERD develop Barrett's esophagus. We sought to identify factors that increase the risk of Barrett's esophagus in those with GERD.
The objective of this matched case-control study was to investigate possible clinical risk factors for Barrett's esophagus.
The study was based on 79 case patients with Barrett's esophagus and 180 control patients. Each case patient was matched to one control patient whose indication for endoscopy was GERD and one control patient who underwent endoscopy for other indications. The case and control patients were matched for age, gender, and race. All patients underwent endoscopy at Duke University Medical Center, Durham, NC, between July 1992 and August 1994.
On average, patients with Barrett's esophagus developed reflux symptoms at an earlier age than age- and gender-matched control patients and also had a longer duration of symptoms. Complications of reflux, including esophagitis, stricture, and ulceration, were reported significantly more frequently in the group of case patients than either group of control patients.
The results of this pilot study indicate that age of onset, duration of symptoms, and complications of GERD may be markers of increased risk of Barrett's esophagus.
巴雷特食管是一种食管的复层鳞状上皮被具有恶变潜能的柱状上皮所取代的病症。慢性胃食管反流病（GERD）被认为是巴雷特食管发生的主要危险因素，但只有一小部分GERD患者会发展为巴雷特食管。我们试图确定在GERD患者中增加巴雷特食管风险的因素。
这项匹配病例对照研究的目的是调查巴雷特食管可能的临床危险因素。
该研究基于79例巴雷特食管病例患者和180例对照患者。每例病例患者与一名因GERD接受内镜检查的对照患者以及一名因其他指征接受内镜检查的对照患者进行匹配。病例和对照患者在年龄、性别和种族方面进行匹配。所有患者于1992年7月至1994年8月在北卡罗来纳州达勒姆的杜克大学医学中心接受内镜检查。
平均而言，巴雷特食管患者出现反流症状的年龄比年龄和性别匹配的对照患者更早，且症状持续时间更长。病例组患者中反流并发症，包括食管炎、狭窄和溃疡的报告频率明显高于两组对照患者。
这项初步研究的结果表明，发病年龄、症状持续时间和GERD并发症可能是巴雷特食管风险增加的标志。
