摘要
在西方国家,食管腺癌(EAC)发病率逐年增加,且EAC与Barrett食管(BE)密切相关。近年来我国众多学者对BE和EAC发病情况进行了深入研究,但尚无文献对其进行总结分析。本文通过检索PubMed和中国医学文献数据库,分析了近年来有关我国BE和EAC研究的文章,探讨我国BE和EAC的发病情况和临床病理特点。检索词包括"Barrett食管"、"食管腺癌"、"中国人"和"中国"。通过分析发现,我国伴肠化生的BE检出率很低,一般人群为0.06%,有症状者检出率为1.8%。目前已确定我国BE的危险因素有老年和食管裂孔疝,其他可能的危险因素包括胃食管反流病、吸烟和酗酒。我国BE的发生与性别和肥胖无关。内镜下大多数柱状上皮食管和BE呈舌状或岛状,长度<2 cm;我国长段BE非常罕见,尤其在女性人群中。近十年台湾和香港地区EAC的发病率很低,部分地区甚至有降低趋势。我国食管下段腺癌较少见,几乎所有胃食管连接(GEJ)处癌均以胃近端为中心生长。柱状上皮食管的临床意义及其是否存在恶变风险目前尚不清楚,需加大样本量进行更深入的研究。
The incidence of esophageal adenocarcinoma （EAC） increases gradually in western countries, and EAC is closely related to Barrett esophagus （BE）. There are many studies on prevalence of BE and EAC in China in recent years. However, no literature was seen to summarize and analyze the results of these studies. We aimed to review and analyze the published results of these studies by searching Pubmed and Chinese Medical Literatures Database with following key words： BE, EAC, Chinese, and China. It was found that BE with intestinal metaplasia was rare in China, ranging from 0.06% in general population to 〈1.8% in referral patients. Risk factors included advancing age, hiatal hernia, and also probably gastroesophageal reflux disease （GRED） and tobacco-alcohol abuse; but male gender and obesity were not. Under endoscopy, most of columnar-lined esophagus （CLE）/BE were 〈2 cm in length, and showed tongue- and island-like appearances. Long-segment BE was rare, especially in women. Studies conducted in Taiwan and Hong Kong indicated that the incidence of EAC was low and even displaying a decreasing tendency in some areas over the past decade. EAC was relatively rare and almost all gastroesophageal junction （GEJ） cancers were centered at the proximal stomach. The clinical significance and malignant potential of CLE in Chinese population remain elusive, and needs further large sample size investigation on BE and BE-related diseases.
出处
《胃肠病学》
2012年第3期129-134,共6页
Chinese Journal of Gastroenterology
