Esophagitis: Incidence and risk of esophageal adenocarcinoma - A population-based cohort study
Esophagitis: Incidence and risk of esophageal adenocarcinoma - A population-based cohort study
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DOI：
10.1111/j.1572-0241.2006.00550.x
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发表时间：
2006-06-01
影响因子：
9.8
通讯作者：
de Muckadell, OBS
中科院分区：
文献类型：
--
作者：
Lassen, A;Hallas, J;de Muckadell, OBS
目的：虽然反流的症状是常见的，我们的知识的流行病学和胃食管反流病的自然史是稀疏的。食管腺癌的风险增加患者的酸反流，但巴雷特病变的贡献是未知的。为了估计先前诊断为食管炎的患者中诊断为内镜下食管炎病变的发生率和食管腺癌的风险，我们提取了内镜检查、食管炎诊断、从1974年至2002年期间的五个基于人口的数据库中诊断出的胃食管癌和胃食管癌，结果：2002年，食管炎病变的发病率为2.4/1000人-年（95%置信区间2.3-2.6），18.3/1000人（17.9-18.7）既往诊断为食管炎。发病率随日历年和年龄的增加而增加，男性高于女性，且与内窥镜检查率密切相关。在11，129例既往诊断为食管炎的患者中，15例在58，322人-年随访期间患有食管腺癌（26例/100，000人-年）。标准化发病比为5.38（3.01-8.87）。15例食管腺癌患者中有10例先前诊断为Barrett食管.结论：食管腺癌的风险增加5倍，在先前诊断为食管炎的患者，但大多数腺癌发生在Barrett食管患者。
OBJECTIVES: Although symptoms of reflux are common, our knowledge of the epidemiology and natural history of gastroesophageal reflux disease is sparse. The risk of esophageal adenocarcinoma is increased among patients with acid reflux, but the contribution of Barrett's lesions is unknown.METHODS: With the aim to estimate the incidence of diagnosed endoscopic esophagitis lesions and the risk of esophageal adenocarcinoma among patients with previously diagnosed esophagitis, we extracted data on endoscopies, esophagitis diagnoses, and gastroesophageal cancer diagnoses from five population-based databases covering the period from 1974 to 2002, and covering all citizens in Funen County (population 470,000).RESULTS: In 2002, the incidence of esophagitis lesions was 2.4 per 1,000 person-years (95% confidence interval 2.3-2.6), 18.3 per 1,000 persons (17.9-18.7) had previously diagnosed esophagitis. Incidence increased by calendar year and age, was higher among males than among females, and was closely related to rate of endoscopy. Among 11,129 patients with previously diagnosed esophagitis, 15 had esophageal adenocarcinoma during 58,322 person-years of follow-up (26 per 100,000 person-years). The expected number was 2.79 and the standardized incidence ratio was 5.38 (3.01-8.87). Ten of the 15 patients with esophageal adenocarcinoma had previously diagnosed Barrett's esophagus.CONCLUSION: The risk of esophageal adenocarcinoma is increased fivefold in patients with previously diagnosed esophagitis, but most of the adenocarcinomas occurred among patients with Barrett's esophagus.