Association between gastroesophageal flap valve, reflux esophagitis, Barrett's epithelium, and atrophic gastritis assessed by endoscopy in Japanese patients
Association between gastroesophageal flap valve, reflux esophagitis, Barrett's epithelium, and atrophic gastritis assessed by endoscopy in Japanese patients
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DOI：
10.1007/s00535-002-1100-9
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发表时间：
2003-01-01
影响因子：
6.3
通讯作者：
Arakawa, T
中科院分区：
文献类型：
--
作者：
Fujiwara, Y;Higuchi, K;Arakawa, T
背景胃食管瓣阀（GEFV）的内镜分级是胃食管反流状态的有用预测因子; GEFV异常与反流性食管炎相关。萎缩性胃炎常见于日本患者，与反流性食管炎呈负相关。本研究的目的是通过前瞻性内窥镜评估来检查GEFV、反流性食管炎、Barrett上皮和萎缩性胃炎之间的关系。方法.我们招募了548名日本患者（296名男性和252名女性;平均年龄57.3岁）。GEFV按Hill及其同事的分类进行评估，反流性食管炎按洛杉矶分类进行评估，萎缩性胃炎的程度评分为：无、轻度、中度或重度。Barrett上皮通过内窥镜检测到柱状衬里向上移位而被识别。结果反流性食管炎42例（7.7%），Barrett上皮67例（12.2%）。反流性食管炎和Barrett上皮的患病率增加与GEFV分级增加相关。异常GEFV（III级和IV级）是反流性食管炎的风险（校正比值比[OR]），13.33（95%置信区间[CI]，6.08-29.25）和Barrett上皮（OR，3.55 [95%CI，2.04-6.20]），而萎缩性胃炎的存在与反流性食管炎呈负相关（OR，0.15 [95%CI，0.07-0.36]），但与Barrett上皮的患病率无关（OR，1.16 [95%CI，0.67-2.01]）。Barrett上皮的患病率和萎缩性胃炎的严重程度随年龄的增加而增加，而反流性食管炎和GEFV异常的患病率和严重程度无明显变化。结论.反流性食管炎和Barrett上皮与日本患者GEFV异常相关萎缩性胃炎的存在与反流性食管炎呈负相关，但与日本患者的Barrett上皮无关。
Background. Endoscopic grading of the gastroesophageal flap valve (GEFV) is a useful predictor of gastroesophageal reflux status; abnormal GEFV was associated with reflux esophagitis. Atrophic gastritis is often found in Japanese patients and is inversely related to reflux esophagitis. The aim of this study was to examine the association between GEFV, reflux esophagitis, Barrett's epithelium, and atrophic gastritis in Japanese patients by prospective endoscopic assessment. Methods. We enrolled 548 Japanese patients (296 men and 252 women; mean age, 57.3 years). GEFV was assessed by the classification of Hill and colleagues, reflux esophagitis was assessed by the Los Angeles classification, and the degree of atrophic gastritis was scored as: none, mild, moderate, or severe. Barrett's epithelium was recognized by the endoscopic detection of an upward shift in the columnar lining. Results. Reflux esophagitis and Barrett's epithelium were found in 42 (7.7%) and 67 (12.2%) patients, respectively. An increased prevalence of reflux esophagitis and Barrett's epithelium was correlated with an increased grade of GEFV. Abnormal GEFV (grades III and IV) was a risk for reflux esophagitis (adjusted odds ratio [OR]), 13.33 (95% confidence interval [CI], 6.08-29.25) and Barrett's epithelium (OR, 3.55 [95% CI, 2.04-6.20]), while the presence of atrophic gastritis was inversely associated with reflux esophagitis (OR, 0.15 [95% CI, 0.07-0.36]), but it was not associated with the prevalence of Barrett's epithelium (OR, 1.16 [95% CI, 0.67-2.01]). The prevalence of Barrett's epithelium and the severity of atrophic gastritis increased with age, while that of reflux esophagitis and abnormal GEFV did not change. Conclusions. Reflux esophagitis and Barrett's epithelium are associated with abnormal GEFV in Japanese patients. The presence of atrophic gastritis is inversely related to reflux esophagitis, but it is not related to Barrett's epithelium in Japanese patients.