Barrett's Esophagus: Risk Factors in Women

描述（由申请方提供）：项目总结：Barrett食管（BE）是食管内层的化生性变化，正常鳞状上皮被特化柱状上皮取代。BE的重要性在于其恶性潜能 BE患者发生食管腺癌的风险是普通人群的30-120倍。据估计，10%的慢性胃灼热患者患有BE，约25%的BE受试者为女性。到目前为止，我们对女性和男性之间BE风险因素差异的理解是有限的，因为包括女性的少数研究是单中心报告，患者人数较少。我们的长期目标是了解女性和男性BE的风险因素。该二次数据分析的具体目的是：1）评价女性BMI与Barrett食管之间的相关性以及与男性相比的相关性，2）评价女性体脂分布与Barrett食管之间的相关性以及与男性相比的相关性，3）评价女性吸烟状况与Barrett食管之间的相关性以及与男性相比的相关性。 我们的研究计划是进行一项病例对照研究，结合来自五个参加新的NIH联盟，巴雷特食管和食管腺癌联盟（BEACON）的网站的数据。参与研究中心将包括：Kaiser Permanente，北方加州，Fred哈钦森癌症研究所，北卡罗来纳州大学，北方爱尔兰影响Barrett's/腺癌关系的因素（FINBAR）研究组，以及澳大利亚Barrett's食管和食管腺癌研究组。总体而言，这些研究包含约1，309例Barrett食管病例（约327名女性）、1551例GERD对照（约388名女性）和1359例人群对照（约340名女性）。病例为BE女性和男性;对照为两组，有反流症状的受试者和人群对照。数据将被整理，并放置在一个中央储存库。将进行多变量逻辑回归，并使用最大似然法估计模型变量。我们的预期结果将确定三个可改变的风险因素和巴雷特食管之间的关系，以及它们如何在女性和男性之间差异表达。该项目对NIDDK RFA，PA-06-151的响应表明了该项目与研究所的相关性。这RFA促进二次分析数据作为一种经济的方式检查重要的研究问题。项目叙述 巴雷特食管（BE）是一种非常常见的食管癌前病变。虽然大约四分之一的BE患者是女性，但在了解女性这种情况的风险因素以及它们与男性风险因素的差异方面，几乎没有做过什么工作。通过研究女性BE的三个潜在风险因素（吸烟，体型和体脂分布），我们希望更好地了解这种情况如何发展以及为什么它在女性和男性中表现不同。

DESCRIPTION (provided by applicant): Project Summary: Barrett's esophagus (BE) is a metaplastic change of the lining of the esophagus, with the normal squamous epithelium replaced by specialized columnar epithelium. The significance of BE lies in its malignant potential subjects with BE have a risk of developing adenocarcinoma of the esophagus that is 30-120 times that of the general public. It is estimated that 10% of those with chronic heartburn harbor BE, and approximately 25% of subjects with BE are women. To date, our understanding of how risk factors for BE differ between women and men is limited because the few studies including women are single center reports featuring small numbers of patients. Our long-term goal is to understand the risk factors for BE in women and men. The specific aims of this secondary data analysis are: 1) To evaluate the association between BMI and Barrett's esophagus in women and compared to men, 2) To evaluate the association between body fat distribution and Barrett's esophagus in women and compared to men, and, 3) To evaluate the association between smoking status and Barrett's esophagus in women and compared to men. Our research plan is to perform a case-control study by combining data from five sites participating in the new NIH consortium, the Barrett's Esophagus and Esophageal Adenocarcinoma Consortium (BEACON). Participating sites will include: Kaiser Permanente, Northern California, the Fred Hutchinson Cancer Institute, the University of North Carolina, the Northern Irish Factors Influencing Barrett's/Adenocarcinoma Relationship (FINBAR) study group, and the Australian Barrett's Esophagus and Esophageal Adenocarcinoma study group. Collectively, these studies contain approximately 1,309 cases of Barrett's esophagus with approximately 327 women, 1551 GERD controls (approximately 388 women) and 1359 population controls (approximately 340 women) Cases will be women and men with BE; controls will be two groups, subjects with reflux symptoms, and population controls. The data will be collated, and placed in a central repository. Multivariate logistic regression will be performed, and model variables will be estimated using maximum likelihood methods. Our expected results will define the relationship between three modifiable risk factors and Barrett's esophagus, and how they may be differentially expressed between women and men. The relevance of this project to the Institute is demonstrated by its responsiveness to NIDDK RFA, PA-06-151. This RFA promotes secondary analysis of data as an economical way of examining important research questions. Project Narrative Barrett's esophagus (BE) is a precancerous condition of the esophagus that is very common. Although about one quarter of people with BE are women, little work has been done to understand the risk factors for this condition among women and how they differ from risk factors among men. By studying three potential risk factors for BE in women (tobacco smoking, body size, and body fat distribution), we hope to better understand how this condition develops and why it behaves differently in women and men.