Oesophageal adenocarcinoma and prior diagnosis of Barrett's oesophagus: a population-based study
Oesophageal adenocarcinoma and prior diagnosis of Barrett's oesophagus: a population-based study
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DOI：
10.1136/gutjnl-2013-305506
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发表时间：
2015-01-01
期刊：
影响因子：
24.5
通讯作者：
Murray, Liam J.
中科院分区：
文献类型：
--
作者：
Bhat, Shivaram K.;McManus, Damian T.;Murray, Liam J.
目的 巴雷特食管 (BO) 的内窥镜监测提供了检测早期食管腺癌 (OAC) 的机会。我们试图确定在人群基础上既往诊断为 BO 的 OAC 患者的比例，并评估既往诊断为 BO 对生存的影响，同时考虑到导联和时长偏差。设计对 2003 年至 2008 年间北爱尔兰所有 OAC 患者进行一项基于人群的回顾性研究。之前的 BO 诊断是通过与北爱尔兰 BO 登记相关联来确定的。比较了先前有和没有诊断过 BO 的患者之间的诊断分期分布和组织学分级。使用 Cox 模型对先前有和没有诊断过 BO 的患者之间的总生存率进行了比较。评估了根据组织学分级以及导联估计和时长偏倚调整生存差异的效果。结果 共有 716 例 OAC 病例，其中 52 例 (7.3%) 既往有 BO 诊断。先前诊断为 BO 的患者的肿瘤分期明显较低（44.2% 与 11.1% 患有 1 期或 2 期疾病；p
Objective Endoscopic surveillance of Barrett's oesophagus (BO) provides an opportunity to detect early stage oesophageal adenocarcinoma (OAC). We sought to determine the proportion of OAC patients with a prior diagnosis of BO on a population basis and to evaluate the influence of a prior diagnosis of BO on survival, taking into account lead and length time biases.Design A retrospective population-based study of all OAC patients in Northern Ireland between 2003 and 2008. A prior BO diagnosis was determined by linkage to the Northern Ireland BO register. Stage distribution at diagnosis and histological grade were compared between patients with and without a prior BO diagnosis. Overall survival, using Cox models, was compared between patients with and without a prior BO diagnosis. The effect of adjusting the survival differences for histological grade and estimates of lead and length time bias was assessed.Results There were 716 OAC cases, 52 (7.3%) of whom had a prior BO diagnosis. Patients with a prior BO diagnosis had significantly lower tumour stage (44.2% vs 11.1% had stage 1 or 2 disease; p