Risk factors for the development of esophageal adenocarcinoma in Barrett's esophagus
Risk factors for the development of esophageal adenocarcinoma in Barrett's esophagus
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DOI：
10.1111/j.1572-0241.2006.00626.x
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发表时间：
2006-07-01
影响因子：
9.8
通讯作者：
Siersema, Peter D.
中科院分区：
文献类型：
--
作者：
de Jonge, Pieter J. F.;Steyerberg, Ewout W.;Siersema, Peter D.
目的：为了确定Barrett食管（BE）患者食管腺癌（EAC）的危险因素，进行了一项基于医院的病例对照研究，其中包括91例EAC患者和244例对照组，均经组织学证实为BE（> 2 cm），无异型增生或轻度异型增生。通过问卷调查收集有关人口统计学、人体测量学和生活方式特征、体力活动水平、工作姿势、家族史、胃食管反流病（GERD）症状和药物使用的信息。目前吸烟者的病例更多（比值比3.7，95%置信区间1.4-9.9），20岁时评估的体重指数> 25（2.6，1.2-5.5），并更频繁地在20岁（2.0，1.1-3.9），与对照组相比，一直在弯腰姿势工作。此外，与对照组相比，病例较少出现烧心症状（0.3，0.2-0.5），质子泵抑制剂的使用频率较低（0.1，0.05-0.2），而非甾体抗炎药/阿司匹林的使用在病例中更为常见（1.8，1.1-3.2）。与对照组相比，男性病例更多（91% vs 67%，p < 0.001）。结论：BE患者EAC的风险与GERD的风险因素相关，但GERD无症状。由于这些危险因素在西方国家很常见，它们可能对监测间隔的个体化没有帮助。
OBJECTIVE: To identify risk factors for esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus (BE).METHODS: A hospital-based case-control study was performed in which 91 cases with EAC and 244 controls with histologically confirmed BE (> 2 cm) with no dysplasia or low-grade dysplasia were included. Information on demographic, anthropometric, and lifestyle characteristics, physical activity levels, working posture, family history, gastroesophageal reflux disease (GERD) symptoms, and medication use was collected by questionnaire.RESULTS: Cases more often were current smokers (odds ratio 3.7, 95% confidence interval 1.4-9.9), more often had a body mass index > 25 assessed at age 20 (2.6, 1.2-5.5), and more frequently had been working in a stooped posture at age 20 (2.0, 1.1-3.9), compared to controls. In addition, cases less often experienced symptoms of heartburn (0.3, 0.2-0.5) and less frequently used proton pump inhibitors (0.1, 0.05-0.2), compared to controls, whereas use of nonsteroidal anti-inflammatory drugs/aspirin was more common among cases (1.8, 1.1-3.2). Cases more often were men, compared to controls (91% vs 67%, p < 0.001).CONCLUSION: In patients with BE, the risk of EAC is related to risk factors for GERD, which is, however, asymptomatic. As these risk factors are common in Western countries, they are probably not helpful in individualization of surveillance intervals.