AIM： To determine the risk factors for the development of esophageal adenocarcinoma in these patients with columnar-lined esophagus （CLE）. METHODS： Data collected retrospectively on 597 consecutive patients diagno...AIM： To determine the risk factors for the development of esophageal adenocarcinoma in these patients with columnar-lined esophagus （CLE）. METHODS： Data collected retrospectively on 597 consecutive patients diagnosed at endoscopy and histology to have CLE at Leeds General Infirmary between 1984 and 1995 were analyzed. Factors evaluated included age, sex, length of columnar segment, smoking, and drinking habits, history of non-steroidal ingestion, presence of endoscopic esophagitis, ulceration or benign strictures and presence of Helicobacter pylori in esophageal biopsies. Univariate and multivariate analyses were performed to identify risk factors for the development of adenocarcinoma. RESULTS： Forty-four patients presented or developed esophageal adenocarcinoma during follow-up. Independent risk factors for the development of adenocarcinoma in palJents with CLE were males （OR 5.12, 95%CI 2.04-12.84, P = 0.0005）, and benign esophageal stricture （OR 4.37, 95%CI 2.02-9.45, P = 0.0002）. Male subjects and patients who developed benign esophageal stricture constituted 86% （n = 38） of all patients who presented or developed esophageal adenocarcinoma. The presence of esophagitis was associated with a significant reduction in the development of esophageal carcinoma （OR 0.28, 95%CI 0.13-0.57, P = 0.0006）. No other clinical characteristics differentiate between the non-malignant and malignant group. CONCLUSION： In patients with CLE, endoscopic surveillance for the early detection of adenocarcinoma may be restricted to male subjects, as well as patients who develop benign esophageal strictures.展开更多
Since its initial description, the pathogenesis of the columnar-lined esophagus （CLE） has been surrounded by many controversies. The first controversy is related to the existence of the condition itself. The second ...Since its initial description, the pathogenesis of the columnar-lined esophagus （CLE） has been surrounded by many controversies. The first controversy is related to the existence of the condition itself. The second controversy centers on whether the CLE is a congenital or an acquired condition. In this article, we review the congenital and acquired theories of development of CLE and discuss the various factors in acquisition of CLE. The bulk of evidence in the literature suggests that CLE is an acquired condition.展开更多
文摘AIM： To determine the risk factors for the development of esophageal adenocarcinoma in these patients with columnar-lined esophagus （CLE）. METHODS： Data collected retrospectively on 597 consecutive patients diagnosed at endoscopy and histology to have CLE at Leeds General Infirmary between 1984 and 1995 were analyzed. Factors evaluated included age, sex, length of columnar segment, smoking, and drinking habits, history of non-steroidal ingestion, presence of endoscopic esophagitis, ulceration or benign strictures and presence of Helicobacter pylori in esophageal biopsies. Univariate and multivariate analyses were performed to identify risk factors for the development of adenocarcinoma. RESULTS： Forty-four patients presented or developed esophageal adenocarcinoma during follow-up. Independent risk factors for the development of adenocarcinoma in palJents with CLE were males （OR 5.12, 95%CI 2.04-12.84, P = 0.0005）, and benign esophageal stricture （OR 4.37, 95%CI 2.02-9.45, P = 0.0002）. Male subjects and patients who developed benign esophageal stricture constituted 86% （n = 38） of all patients who presented or developed esophageal adenocarcinoma. The presence of esophagitis was associated with a significant reduction in the development of esophageal carcinoma （OR 0.28, 95%CI 0.13-0.57, P = 0.0006）. No other clinical characteristics differentiate between the non-malignant and malignant group. CONCLUSION： In patients with CLE, endoscopic surveillance for the early detection of adenocarcinoma may be restricted to male subjects, as well as patients who develop benign esophageal strictures.
文摘Since its initial description, the pathogenesis of the columnar-lined esophagus （CLE） has been surrounded by many controversies. The first controversy is related to the existence of the condition itself. The second controversy centers on whether the CLE is a congenital or an acquired condition. In this article, we review the congenital and acquired theories of development of CLE and discuss the various factors in acquisition of CLE. The bulk of evidence in the literature suggests that CLE is an acquired condition.
