短节段Barrett’s食管的内镜和病理分析

Endoscopic and pathological study on short-segment Barrett's esophagus

目的研究内镜和病理下短节段Barrett’s食管(SSBE)的临床症状、内镜分型和病理特征之间的关系。方法对140例内镜和病理诊断为SSBE的患者进行临床症状评估,组织标本HE染色,并对临床症状、内镜分型及病理特征之间的关系进行相关分析。结果SSBE的内镜检出率为9.75%,男女比为1.12∶1,平均发病年龄为51.64岁,有典型胃食管反流病(GERD)症状占70.00%;140例患者中反酸54例,烧心18例,胸骨后痛31例,上腹痛29例,无症状8例。140例患者中病理诊断胃底腺者30例,贲门腺者98例,肠上皮化生者12例;内镜诊断岛型54例,舌型66例,全周型20例。140例患者中贲门腺组反酸、烧心、胸骨后痛、无症状的发生率与其他两组比较明显增高。140例患者中贲门腺组内镜表现为舌型和岛型的检出率明显高于其他两组。主要临床症状的发生率在三种内镜类型之间比较差异无统计学意义。结论SSBE病理特征和胃食管反流症状的发生,以及病理特征和内镜分型之间均密切相关,SSBE临床症状和内镜分型之间无明显关系。

Objective To study the relationship among clinical manifestation,endoscopic classification and pathological character of short-segment Barrett＇s esophagus（SSBE）.Methods Clinical symptom,endoscopic classification and pathological character were assessed among 140 SSBE patients diagnosed by endoscopy and pathology.Results The detection rate of SSBE undergoing endoscopy was 9.75%.The ratio of male and female was 1.12∶1 and the average age of onset was 51.64 years old.And 70.00%of patients with SSBE occurred specific symptoms for gastroesophageal reflux disease（GERD）.SSBE patients included 54 cases of acid reflux,18 cases of heartburn,31 cases of chest pain,29 cases of epigastric pain and 8 cases of no symptom.Pathological diagnosis included 98 cases of cardiac-type,30 cases of gastric fundic-type and 12 cases of special intestinal metaplasia（SIM）-type.Endoscopic diagnosis included 54 cases of island-type,66 cases of tongue-type and 20 cases of circumferential-type.The occurring rates of acid reflux,heartburn,chest pain and no symptom in patients with cardiac-type were significantly higher than those in other types.The detection rates of island and tongue in cardiac-type were higher than those in other types.There was no significant difference between clinical manifestation and endoscopic classification.Conclusion Clinical manifestation of SSBE is closely related to pathological character and endoscopic classification.There is no relationship between clinical manifestation and endoscopic classification.