Specialized intestinal metaplasia, dysplasia, and cancer of the esophagus and esophagogastric junction : Prevalence and clinical data.
Background & Aims
Adenocarcinoma of the esophagus and esophagogastric junction (EGJ) is increasing, the earliest lesion being specialized intestinal metaplasia (SIM).
This study determined the prevalence and demographic features of patients with SIM, dysplasia, and cancer in the esophagus and EGJ.
Two antegrade biopsy specimens were taken distal to the squamocolumnar junction (SCJ) and any tongues of pink mucosa proximal to the SCJ.
Patients were categorized endoscopically and histologically as having long-segment (LSBE) or short-segment Barrett's esophagus (SSBE), EGJ-SIM, or a normal EGJ.
Of 889 patients studied, 56 were undergoing esophagoduodenoscopy screening or surveillance and were not included in the prevalence calculation.
The overall prevalence of SIM was 13.2%, with 1.6% LSBE, 6.0% SSBE, and 5.6% EGJ-SIM.
Dysplasia or cancer was noted in 31% of LSBE, 10% of SSBE, and 6.4% of EGJ-SIM patients (P <= 0.043).
Two cancers were associated with LSBE, 1 with SSBE, and 1 with EGJ-SIM.
Patients with LSBE and SSBE were predominantly white (P <= 0.001), male (P <= 0.009), and smokers (P <= 0.004), with LSBE patients having a longer history of heartburn (P <= 0.009).
In contrast, patients with EGJ-SIM were similar in gender and ethnicity to the reference group, tended to be older (P <= 0.05), drank less alcohol (P <= 0.02), and had a higher prevalence of Helicobacter pylori infection (P <= 0.05). (...)
Mots-clés Pascal : Métaplasie intestinale, Spécificité, Prévalence, Carcinome, Oesophage, Jonction oesogastrique, Laparoscopie, Biopsie, Dépistage, Facteur sociodémographique, Exploration clinique, Base donnée, Homme, Etats Unis, Amérique du Nord, Amérique, Appareil digestif pathologie, Intestin pathologie, Tumeur maligne, Oesophage pathologie, Endoscopie
Mots-clés Pascal anglais : Intestinal metaplasia, Specificity, Prevalence, Carcinoma, Esophagus, Gastroesophageal junction, Laparoscopy, Biopsy, Medical screening, Sociodemographic factor, Clinical investigation, Database, Human, United States, North America, America, Digestive diseases, Intestinal disease, Malignant tumor, Esophageal disease, Endoscopy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0233730
Code Inist : 002B24E06. Création : 16/11/1999.