Familial aggregation of gastroesophageal reflux in patients with Barrett's esophagus and esophageal adenocarcinoma
Familial aggregation of gastroesophageal reflux in patients with Barrett's esophagus and esophageal adenocarcinoma
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DOI：
10.1053/gast.1997.v113.pm9352846
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发表时间：
1997-11-01
期刊：
影响因子：
29.4
通讯作者：
Melton, LJ
中科院分区：
文献类型：
--
作者：
Romero, Y;Cameron, AJ;Melton, LJ
背景与目的：巴雷特食管和腺癌是胃食管反流病的并发症。本研究的目的是寻找反流家族倾向的证据。方法：从三级医疗机构和社区人群中招募腺癌 (n = 27)、巴雷特食管 (n = 40) 和反流性食管炎 (n = 55) 的指标患者。患者的父母和兄弟姐妹（n = 243）及其配偶的亲属（n = 230）完成了反流症状调查问卷（答复率为86％）。结果：腺癌患者（43% vs. 23%）和巴雷特食管患者（46% vs. 27%）的父母和兄弟姐妹中，反流症状明显高于配偶对照亲属。反流性食管炎组没有发现显着差异（33% vs. 29%）。巴雷特食管（41% vs. 12%）和腺癌（40% vs. 6%）患者的兄弟姐妹中反流更为常见，而反流性食管炎则没有发现这种差异（24% vs. 32%）。反流与肥胖相关，非肥胖人群中反流比例为 41%，而非肥胖人群中反流比例为 28%；吸烟者为 45%，不吸烟者为 31%；男性为 39%，女性为 27%。结论：巴雷特食管和食管腺癌患者的家族中可能存在发生反流的遗传倾向。对于无并发症的反流性食管炎，环境因素显得更为重要。
Background & Aims: Barrett's esophagus and adenocarcinoma are complications of gastroesophageal reflux disease. The aim of this study was to look for evidence of a familial predisposition to reflux. Methods: Index patients with adenocarcinoma (n = 27), Barrett's esophagus (n = 40), and reflux esophagitis (n = 55) were recruited from tertiary care and community populations. Parents and siblings of patients (n = 243) and their spouses' relatives (n = 230) completed reflux symptom questionnaires (response rate, 86%). Results: Reflux symptoms were significantly more prevalent among parents and siblings of patients with adenocarcinoma (43% vs. 23%) and Barrett's esophagus (46% vs. 27%) than spouse control relatives. No significant difference was found for the reflux esophagitis group (33% vs. 29%). Reflux was more prevalent in siblings than spouses of patients with Barrett's esophagus (41% vs. 12%) and adenocarcinoma (40% vs. 6%), a difference that was not found with reflux esophagitis (24% vs. 32%). Reflux was associated with obesity, 41% vs. 28% in the nonobese; smoking, 45% vs. 31% in nonsmokers; and men, 39% vs. 27% in women. Conclusions: There may be a genetic predisposition to the development of reflux in families of patients with Barrett's esophagus and esophageal adenocarcinoma. For uncomplicated reflux esophagitis, environmental factors appear more important.