Barrett's esophagus in Japanese patients: its prevalence, form, and elongation
Barrett's esophagus in Japanese patients: its prevalence, form, and elongation
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DOI：
10.1007/s00535-008-2261-y
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发表时间：
2008-12-01
影响因子：
6.3
通讯作者：
Kinoshita, Yoshikazu
中科院分区：
文献类型：
--
作者：
Okita, Koichi;Amano, Yuji;Kinoshita, Yoshikazu
巴雷特食管是一种众所周知的后天性疾病，由胃食管反流病（GERD）引起。然而，目前还不清楚巴雷特食管是否会随着时间的推移在GERD患者中逐渐发展。为了解决这个问题，我们调查了短节段Barrett食管（SSBE）的患病率和长度随时间的变化，从2005年1月至2007年3月，我们纳入了5338例接受上消化道内镜检查的患者。根据10岁的年龄间隔分组，对内镜检查发现的SSBE的患病率和持续时间进行评价。可能影响SSBE长度的因素，如症状，抗酸剂的使用和内镜检查结果也进行了评价。此外，在2年的随访中，对236例经组织学证实的Barrett食管患者的长度变化进行了评价。在5338例入选患者中，1997例有SSBE。老年患者内镜下发现SSBE的患病率明显较高，其长度明显较长。多元回归分析显示年龄、反流性食管炎、反流症状和食管裂孔疝与SSBE长度呈正相关。对组织学证实的SSBE的2年随访研究的分析显示，236例患者中有28.0%的Barrett长度显著延长。存在反流症状和食管裂孔疝被确定为SSBE延长的阳性预测因子，质子泵抑制剂给药被确定为SSBE延长的阴性预测因子。SSBE延长的阳性预测因子是存在食管裂孔疝和反流症状，而不是年龄。
Barrett's esophagus is a well-known acquired condition resulting from gastroesophageal reflux disease (GERD). However, it is still unknown whether Barrett's esophagus develops gradually over time in patients with GERD. To address this issue, we investigated the change in the prevalence and length of short-segment Barrett's esophagus (SSBE) over time.From January 2005 to March 2007, we enrolled 5338 patients who received upper gastrointestinal endoscopy. Prevalence and length of endoscopically identified SSBE were evaluated within groups divided on the basis of 10-year age intervals. The factors possibly influencing SSBE length such as symptoms, antacid use, and endoscopic findings were also evaluated. Additionally, the length change in 236 patients with histologically confirmed Barrett's esophagus was evaluated over a 2-year follow-up.Of the 5338 enrolled patients, 1997 had SSBE. The prevalence of endoscopically identified SSBE was significantly higher and its length was significantly longer in elderly patients. Multiple regression analysis showed that age, presence of reflux esophagitis, reflux symptoms, and hiatal hernia were positively correlated with SSBE length. Analysis of the 2-year follow-up study of histologically confirmed SSBE revealed significant extension of Barrett's length in 28.0% of 236 patients. Presence of reflux symptoms and hiatal hernia were identified as positive predictors and proton pump inhibitor administration as a negative predictor of SSBE elongation.Positive predictors for the extension of SSBE were presence of hiatal hernia and reflux symptoms, but not age.