Clinical Outcomes Based on the Timing of Appearance of Visible Lesions in Barrett's Esophagus During Endoscopic Eradication Therapy.
Clinical Outcomes Based on the Timing of Appearance of Visible Lesions in Barrett's Esophagus During Endoscopic Eradication Therapy.
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基于内镜根除治疗期间巴雷特食管可见病变出现时间的临床结果。
DOI：
10.1097/mcg.0000000000001165
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发表时间：
2020
影响因子：
2.9
通讯作者：
Lopez,Rocio
中科院分区：
文献类型：
--
作者：
Thota,PrashanthiN;Benjamin,Tanmayee;Sanaka,MadhusudhanR;Goldblum,JohnR;Vargo,John;Jang,Sunguk;Lopez,Rocio
结果：共有 264 名患者，其中 34 名患有扁平不典型增生，180 名患者在开始 EET 之前出现 VL（普遍病变），50 名患者在 EET 期间出现 VL（偶发病变）。与扁平不典型增生患者相比，VL患者BE段较长（5 vs. 4 cm，P=0.002），高度不典型增生（HGD）或食管腺癌（EAC）的患病率较高（63.6% vs. 29.4%，P<0.001）。与普遍病变相比，偶发病变不太可能含有 HGD/EAC（28.1% vs. 61.8%，P<0.001）。各组之间化生/不典型增生的根除没有显着差异。扁平不典型增生组未观察到进展或复发。 VL 组中，14 例患者进展（流行 VL=11，事件 VL=3），15 例复发（流行 VL=11，事件 VL=4）。结论：约 19% 的 BE 患者在 EET 期间出现 VL。与偶发 VL 相比，流行 VL 中 HGD/EAC 的患病率更高。然而，结果并没有不同。
Results:There were 264 patients of which 34 had flat dysplasia, 180 had VL before initiating EET (prevalent lesions) and 50 who developed VL during EET (incident lesions). Compared with patients with flat dysplasia, patients with VL had longer segments of BE (5 vs. 4 cm, P= 0.002) and greater prevalence of high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC)(63.6% vs. 29.4%, P< 0.001). Incident lesions are less likely to harbor HGD/EAC compared with prevalent lesions (28.1% vs. 61.8%, P< 0.001). There were no significant differences in eradication of metaplasia/dysplasia between the groups. No progression or recurrences were observed in flat dysplasia group. In VL group, 14 patients progressed (prevalent VL= 11, incident VL= 3) and 15 had recurrences (prevalent VL= 11, incident VL= 4).Conclusions:About 19% of BE patients developed VL during EET. There is higher prevalence of HGD/EAC in prevalent VL compared with incident VL. However, the outcomes did not differ.