巴雷特食道:两个胃食道逆流性疾病队列之间的比较研究
Krishnadas Devadas1, Bony George2, Jijo Varghese3
1Professor and Head of the Department.
The Journal of the Association of Physicians of India
|June 25, 2023
概括
巴雷特食道 (Barrett's esophagus,BE) 在科塔比在特里万德鲁姆更为普遍,增加了癌症的风险. 这凸显了GERD注册需要针对高风险人群进行早期干预的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 巴雷特食道 (BE) 是胃食道逆流性疾病 (GERD) 的并发症,具有恶性潜力.
- 对于BE发展的风险因素是多样化的,需要在相似的地理区域进行比较研究.
- 在BE中,癌症的每年进展取决于是否存在发育不良.
研究的目的:
- 为了比较巴雷特食道 (Barrett's esophagus,BE) 的患病率和相关风险因素在科塔和特里万德鲁姆的两个有症状的GERD队列中.
- 分析两个地理上相邻的队列之间的BE发展的促成因素.
主要方法:
- 一项横截面研究比较了来自科塔和特里万德鲁姆的两个GERD队列.
- 由于活检数据不完整,用于巴雷特食道 (BE) 的替代品是内镜疑似食道转化症 (ESEM).
- 分析了包括年龄,GERD症状持续时间,间歇性,体重指数 (BMI),侵蚀性食道炎和胃炎等因素.
主要成果:
- 巴雷特食道 (Barrett's esophagus,BE),特别是长段的BE,在科塔亚姆队列 (68比22) 比在特里万德鲁姆队列 (36比9) (p<0.001) 显著更常见.
- 年龄 (>50岁) 并不是统计学上显著的差异化因素 (平均年龄为49岁与48岁).
- 在Trivandrum,GERD症状的持续时间显著更高 (p<0.001),而在Kottayam,间隙和BMI更为普遍.
结论:
- 科塔雅姆队列的BE患病率较高,表明对远端食道癌的易感性增加.
- 尽管邻近,但在科塔和特里万德鲁姆之间存在明显的BE患病率差异.
- 这些发现强调了GERD登记册对于识别高风险人群的重要性,并使早期干预能够减少远端食道癌发病率.
相关概念视频
Barrett Esophagus-I: Introduction
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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Barrett Esophagus-II: Clinical Manifestations and Management
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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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Gastroesophageal Reflux Disease I: Meaning and Pathophysiology
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Esophageal Strictures-II: Clinical Features and Management
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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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