Radiofrequency Ablation in Barrett's Esophagus with Dysplasia
Radiofrequency Ablation in Barrett's Esophagus with Dysplasia
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DOI：
10.1056/nejmoa0808145
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发表时间：
2009-05-28
影响因子：
158.5
通讯作者：
Lightdale, Charles J.
中科院分区：
文献类型：
--
作者：
Shaheen, Nicholas J.;Sharma, Prateek;Lightdale, Charles J.
巴雷特食管是一种食管肠上皮化生的疾病，与食管腺癌的风险增加有关。我们评估是否内镜射频消融可以根除异型增生的Barrett食管，并降低肿瘤进展的速度。METHODS在一个多中心，假对照试验，我们随机分配127例异型增生的Barrett食管的2：1的比例接受射频消融术（消融组）或假手术（对照组）。根据异型增生的程度和Barrett食管的长度对随机分组进行分层。12个月时的主要结果包括异型增生和肠上皮化生的完全根除。在意向治疗分析中，在低度异型增生患者中，消融组异型增生完全根除率为90.5%，而对照组为22.7%（P
BACKGROUNDBarrett's esophagus, a condition of intestinal metaplasia of the esophagus, is associated with an increased risk of esophageal adenocarcinoma. We assessed whether endoscopic radiofrequency ablation could eradicate dysplastic Barrett's esophagus and decrease the rate of neoplastic progression.METHODSIn a multicenter, sham-controlled trial, we randomly assigned 127 patients with dysplastic Barrett's esophagus in a 2: 1 ratio to receive either radiofrequency ablation (ablation group) or a sham procedure (control group). Randomization was stratified according to the grade of dysplasia and the length of Barrett's esophagus. Primary outcomes at 12 months included the complete eradication of dysplasia and intestinal metaplasia.RESULTSIn the intention-to-treat analyses, among patients with low-grade dysplasia, complete eradication of dysplasia occurred in 90.5% of those in the ablation group, as compared with 22.7% of those in the control group (P