Lifetime risk of esophageal adenocarcinoma in patients with Barrett's esophagus
Lifetime risk of esophageal adenocarcinoma in patients with Barrett's esophagus
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DOI：
10.3748/wjg.v20.i28.9611
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发表时间：
2014-07-28
影响因子：
4.3
通讯作者：
Winslet, Marc
中科院分区：
文献类型：
--
作者：
Gatenby, Piers;Caygill, Christine;Winslet, Marc
目的：探讨Barrett食管患者发生食管腺癌和/或高度不典型增生的终生风险。方法：数据从英国国家Barrett食管登记处提取，包括来自35个英国中心登记的7877名患者的诊断日期、患者年龄和性别。预期寿命根据英国国家统计数据根据性别和诊断时的年龄进行评估。然后将这些数据与发表的来自荟萃分析和大型人群研究的年度腺癌和高度不典型增生发生率估计值一起使用，以估计这些研究终点的总体终生发展风险。结果：男性诊断Barrett食管的平均年龄为61.6岁，女性为67.3岁。男性诊断时的平均预期寿命为23.1岁，女性为20.7岁，总体为22.2岁。根据已发表的荟萃分析数据，患腺癌的终生风险在1 / 8到1 / 14之间，患高度发育不良或腺癌的终生风险在1 / 5到1 / 6之间。根据最近3项基于人群的队列研究的数据，腺癌的终生风险在1 / 10和1 / 37之间，高度发育不良和腺癌的合并终点在1 / 8和1 / 20之间。被诊断为巴雷特食管的年龄在减少，预期寿命在增加，这将部分抵消较低的年癌症发病率。结论：Barrett食管发生高级别发育不良和腺癌的终生风险显著。（三）2014年百世登出版集团股份有限公司版权所有。
AIM: To investigate the lifetime risk of development of esophageal adenocarcinoma and/or high-grade dysplasia in patients diagnosed with Barrett's esophagus.METHODS: Data were extracted from the United Kingdom National Barrett's Oesophagus Registry on date of diagnosis, patient age and gender of 7877 patients from who had been registered from 35 United Kingdom centers. Life expectancy was evaluated from United Kingdom National Statistics data based upon gender and age at year at diagnosis. These data were then used with published estimates of annual adenocarcinoma and high-grade dysplasia incidences from meta-analyses and large population-based studies to estimate overall lifetime risk of development of these study endpoints.RESULTS: The mean age at diagnosis of Barrett's esophagus was 61.6 years in males and 67.3 years in females. The mean life expectancy at diagnosis was 23.1 years in males, 20.7 years in females and 22.2 years overall. Using data from published meta-analyses, the lifetime risk of development of adenocarcinoma was between 1 in 8 and 1 in 14 and the lifetime risk of high-grade dysplasia or adenocarcinoma was 1 in 5 to 1 in 6. Using data from 3 large recent population-based cohort studies the lifetime risk of adenocarcinoma was between 1 in 10 and 1 in 37 and of the combined end-point of high-grade dysplasia and adenocarcinoma was between 1 in 8 and 1 in 20. Age at Barrett's esophagus diagnosis is reducing and life expectancy is increasing, which will partially counter-balance lower annual cancer incidence.CONCLUSION: There is a significant lifetime risk of development of high-grade dysplasia and adenocarcinoma in Barrett's esophagus. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.