Romero Y, Cameron A J, Locke G R, Schaid D J, Slezak J M, Branch C D, Melton L J
Division of Gastroenterology and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Gastroenterology. 1997 Nov;113(5):1449-56. doi: 10.1053/gast.1997.v113.pm9352846.
BACKGROUND & AIMS: Barrett's esophagus and adenocarcinoma are complications of gastroesophageal reflux disease. The aim of this study was to look for evidence of a familial predisposition to reflux.
Index patients with adenocarcinoma (n = 27), Barrett's esophagus (n = 40), and reflux esophagitis (n = 55) were recruited from tertiary care and community populations. Parents and siblings of patients (n = 243) and their spouses' relatives (n = 230) completed reflux symptom questionnaires (response rate, 86%).
Reflux symptoms were significantly more prevalent among parents and siblings of patients with adenocarcinoma (43% vs. 23%) and Barrett's esophagus (46% vs. 27%) than spouse control relatives. No significant difference was found for the reflux esophagitis group (33% vs. 29%). Reflux was more prevalent in siblings than spouses of patients with Barrett's esophagus (41% vs. 12%) and adenocarcinoma (40% vs. 6%), a difference that was not found with reflux esophagitis (24% vs. 32%). Reflux was associated with obesity, 41% vs. 28% in the nonobese; smoking, 45% vs. 31% in nonsmokers; and men, 39% vs. 27% in women.
There may be a genetic predisposition to the development of reflux in families of patients with Barrett's esophagus and esophageal adenocarcinoma. For uncomplicated reflux esophagitis, environmental factors appear more important.
巴雷特食管和腺癌是胃食管反流病的并发症。本研究旨在寻找反流家族易感性的证据。
从三级医疗机构和社区人群中招募腺癌患者（n = 27）、巴雷特食管患者（n = 40）和反流性食管炎患者（n = 55）作为索引病例。患者的父母和兄弟姐妹（n = 243）及其配偶的亲属（n = 230）完成反流症状问卷（应答率为86%）。
腺癌患者和巴雷特食管患者的父母及兄弟姐妹中反流症状的发生率（分别为43%和46%）显著高于配偶对照亲属（分别为23%和27%）。反流性食管炎组未发现显著差异（分别为33%和29%）。巴雷特食管患者和腺癌患者的兄弟姐妹中反流比配偶更常见（分别为41%和40%对比12%和6%），反流性食管炎患者未发现此差异（分别为24%和32%）。反流与肥胖相关，非肥胖者中反流发生率为41%，肥胖者中为28%；与吸烟相关，不吸烟者中反流发生率为45%，吸烟者中为31%；与性别相关，女性中反流发生率为27%，男性中为39%。
巴雷特食管和食管腺癌患者的家族中可能存在反流发生的遗传易感性。对于无并发症的反流性食管炎，环境因素似乎更为重要。
