The purpose of this study was to establish the prevalence of Barrett s esophagus and erosive esophagitis in a group of patients undergoing upper endoscopy for dyspepsia. Computerized endoscopy records were retrospec...The purpose of this study was to establish the prevalence of Barrett s esophagus and erosive esophagitis in a group of patients undergoing upper endoscopy for dyspepsia. Computerized endoscopy records were retrospectively evaluated to identify patients who underwent upper endoscopy for dyspepsia.Objective findings were recorded, including the presence of Barrett s esophagus, erosive esophagitis, and peptic ulcer disease. Among 264 patients, Barrett s esophagus was found in 16 (6.1% ). The mean length of Barrett s was 2.0 cm, and the majority (81.3% ) was short segment. Erosive esophagitis was found in 62 patients (23.% ), and peptic ulcer disease was found in 25 patients (9.5% ). Approximately 30% of patients undergoing endoscopy for dyspepsia had esophageal lesions.The prevalence of Barrett s in this population was 6% . Based on these results, a trial of acid suppression may benefit a third of patients with dyspepsia. Current screening practices for Barrett s in reflux patients alone may need to be reevaluated.展开更多
Background: The reported frequency of Barrett’s esophagus(BE) in patients wit h reflux symptoms varies from 5%to 15%.The exact frequency of long-segment BE (LSBE) (>3 cm) and short-segment BE (SSBE) (< 3 cm) in...Background: The reported frequency of Barrett’s esophagus(BE) in patients wit h reflux symptoms varies from 5%to 15%.The exact frequency of long-segment BE (LSBE) (>3 cm) and short-segment BE (SSBE) (< 3 cm) in patients with chronic s ymptoms of GERD is uncertain. The aim of this study was to determine the frequen cy of LSBE and SSBE in consecutive patients presenting for a first endoscopic ev aluationwith GERD as the indication. Methods: Consecutive patients presenting to the endoscopy unit of a Veterans Affairs Medical Center for a first upper endos copy with the indication of GERD were prospectively evaluated. Demographic infor mation (gender,race, age), data on tobacco use and family history of esophageal disease, and body mass index (BMI) were recorded for all patients. Before endosc opy, all patients completed a validated GERD questionnaire. The diagnosis of BE was based on the presence of columnar-appearing mucosa in the distal esophagus, with confirmation by demonstration of intestinal metaplasia in biopsy specimens . All patients with erosive esophagitis on the initial endoscopy underwent a sec ond endoscopy to document healing and to rule-out underlying BE.Patients with a history of BE, alarm symptoms (dysphagia,weight loss, anemia, evidence of GI bl eeding), or prior endoscopy were excluded. Results: A total of 378 consecutive p atients with GERD (94%men, 86%white; median age 56 years, range 27-93 years) were evaluated. A diagnosis of BE was made in 50 patients (13.2%). The median l ength of Barrett’s esophagus (BE) was 1.0 cm (range 0.5-15.0 cm). Of the patie nts with BE, 64%had short-segment BE (SSBE) (overall SSBE frequency 8.5%). Th e overall frequency of long-segment BE (LSBE) was 4.8%. A hiatal hernia was de tected in 62%of the pati- entswith BE. Of the 50 patientswith BE (median age 62 years, range 29-81 year s), 47 (94%) were men and 98%were white. Eighteen patients (36%) were using t obacco at the time of endoscopy; 23 (46%) were former users. The median body ma ss index (BMI) of patients with BE was 27.3 (overweight).There were no significa nt differences between patients with LSBE and SSBE with respect to age, gender, ethnicity, BMI,and GERD symptom duration. Conclusions: The frequency of BE in a high-risk patient group (chronic GERD, majority white men, age > 50 years) who sought medical attention is 13.2%,with the majority (64%) having SSBE. These d ata suggest that the frequency of BE in patients with GERD has not changed.The t rue prevalence of BE in the general population, including those who do not seek care, is undoubtedly lower, currently and historically. The majority of patients with BE are overweight and have a hiatal hernia. Demographic data for patients with LSBE and SSBE are similar, indicating that these are a continuum of the sam e process.展开更多
Background/Aims: ErbB2 expression in esophageal adenocarcinoma has been shown to correlate with its clinicopathological features. However, expression levels for EGF receptor, erbB2 and erbB3 in specialized columnar ep...Background/Aims: ErbB2 expression in esophageal adenocarcinoma has been shown to correlate with its clinicopathological features. However, expression levels for EGF receptor, erbB2 and erbB3 in specialized columnar epithelium (SCE)of Barrett’s esophagus have yet to be determined. To investigate the relationship between EGF family receptors and Barrett’s esophagus, we examined expression levels for EGF receptor, erbB2 and erbB3 in SCE of Barrett’s esophagus. Methods: 10 consecutive patients with short and long segment Barrett’s esophagus, and 10 control subjects without organic esophagogastric diseases were enrolled. Biopsy samples of Barrett’s mucosa stained or not stained with methylene blue applied endoscopically were used for histological evaluation and Western blot analysis of EGF receptor, erbB2 and erbB3 proteins. Results: Mean length of Barrett’s esophagus was 2.6 cm (range 1-8 cm) and all tissue samples from methylene blue stained Barretts mucosa consisted of non dysplastic SCE. In the Barretts group, Western blot analysis showed that EGF receptor and erbB2 were equally and strongly expressed in SCE and squamous epithelium; in contrast, erbB3 expression in SCE was considerably weaker. In control subjects, all proteins showed strong expression for all samples. Immunohistochemical analysis of SCE in Barretts esophagus showed positive EGF receptor and erbB2 expression, and no erbB3 expression. Conclusions: ErbB2 is strongly expressed in both non dysplastic SCE and squamous epithelium, whereas erbB3 expression is essentially limited to the squamous epithelium.展开更多
Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patient...Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patients with BE(defined by columnar lined esophagus of≥1 cm)and 15 healthy individuals that were matched for age,gender,and body mass index,were recruited.The fasting intragastric p H and the appearance time,length,lowest p H,and mean p H of the PPGAP were determined using a single p H electrode pull-through experiment.For BE patients,a gastroesophageal reflux disease questionnaire(Gerd Q)was completed and esophageal 24-h p H monitoring was carried out.Results:The PPGAP was significantly longer(5(3,5)cm vs.2(1,2)cm)and the lowest p H(1.1(0.8,1.5)vs.1.6(1.4,1.9))was significantly lower in patients with short-segment BE than in healthy individuals.The PPGAP started to appear proximally from the gastroesophageal p H step-up point to the esophageal lumen.The acidity of the PPGAP was higher in the distal segment than in the proximal segment.In short-segment BE patients,there were significant correlations between the acidity and the appearance time and length of the PPGAP.The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes.The acidity of the PPGAP was associated with the De Meester scores,the Gerd Q scores,and the fasting intragastric p H.Conclusions:In patients with short-segment BE,a PPGAP is commonly seen.Its length and acidity of PPGAP are associated with gastroesophageal acid reflux,the De Meester score,and the Gerd Q score in patients with short-segment BE.展开更多
文摘The purpose of this study was to establish the prevalence of Barrett s esophagus and erosive esophagitis in a group of patients undergoing upper endoscopy for dyspepsia. Computerized endoscopy records were retrospectively evaluated to identify patients who underwent upper endoscopy for dyspepsia.Objective findings were recorded, including the presence of Barrett s esophagus, erosive esophagitis, and peptic ulcer disease. Among 264 patients, Barrett s esophagus was found in 16 (6.1% ). The mean length of Barrett s was 2.0 cm, and the majority (81.3% ) was short segment. Erosive esophagitis was found in 62 patients (23.% ), and peptic ulcer disease was found in 25 patients (9.5% ). Approximately 30% of patients undergoing endoscopy for dyspepsia had esophageal lesions.The prevalence of Barrett s in this population was 6% . Based on these results, a trial of acid suppression may benefit a third of patients with dyspepsia. Current screening practices for Barrett s in reflux patients alone may need to be reevaluated.
文摘Background: The reported frequency of Barrett’s esophagus(BE) in patients wit h reflux symptoms varies from 5%to 15%.The exact frequency of long-segment BE (LSBE) (>3 cm) and short-segment BE (SSBE) (< 3 cm) in patients with chronic s ymptoms of GERD is uncertain. The aim of this study was to determine the frequen cy of LSBE and SSBE in consecutive patients presenting for a first endoscopic ev aluationwith GERD as the indication. Methods: Consecutive patients presenting to the endoscopy unit of a Veterans Affairs Medical Center for a first upper endos copy with the indication of GERD were prospectively evaluated. Demographic infor mation (gender,race, age), data on tobacco use and family history of esophageal disease, and body mass index (BMI) were recorded for all patients. Before endosc opy, all patients completed a validated GERD questionnaire. The diagnosis of BE was based on the presence of columnar-appearing mucosa in the distal esophagus, with confirmation by demonstration of intestinal metaplasia in biopsy specimens . All patients with erosive esophagitis on the initial endoscopy underwent a sec ond endoscopy to document healing and to rule-out underlying BE.Patients with a history of BE, alarm symptoms (dysphagia,weight loss, anemia, evidence of GI bl eeding), or prior endoscopy were excluded. Results: A total of 378 consecutive p atients with GERD (94%men, 86%white; median age 56 years, range 27-93 years) were evaluated. A diagnosis of BE was made in 50 patients (13.2%). The median l ength of Barrett’s esophagus (BE) was 1.0 cm (range 0.5-15.0 cm). Of the patie nts with BE, 64%had short-segment BE (SSBE) (overall SSBE frequency 8.5%). Th e overall frequency of long-segment BE (LSBE) was 4.8%. A hiatal hernia was de tected in 62%of the pati- entswith BE. Of the 50 patientswith BE (median age 62 years, range 29-81 year s), 47 (94%) were men and 98%were white. Eighteen patients (36%) were using t obacco at the time of endoscopy; 23 (46%) were former users. The median body ma ss index (BMI) of patients with BE was 27.3 (overweight).There were no significa nt differences between patients with LSBE and SSBE with respect to age, gender, ethnicity, BMI,and GERD symptom duration. Conclusions: The frequency of BE in a high-risk patient group (chronic GERD, majority white men, age > 50 years) who sought medical attention is 13.2%,with the majority (64%) having SSBE. These d ata suggest that the frequency of BE in patients with GERD has not changed.The t rue prevalence of BE in the general population, including those who do not seek care, is undoubtedly lower, currently and historically. The majority of patients with BE are overweight and have a hiatal hernia. Demographic data for patients with LSBE and SSBE are similar, indicating that these are a continuum of the sam e process.
文摘Background/Aims: ErbB2 expression in esophageal adenocarcinoma has been shown to correlate with its clinicopathological features. However, expression levels for EGF receptor, erbB2 and erbB3 in specialized columnar epithelium (SCE)of Barrett’s esophagus have yet to be determined. To investigate the relationship between EGF family receptors and Barrett’s esophagus, we examined expression levels for EGF receptor, erbB2 and erbB3 in SCE of Barrett’s esophagus. Methods: 10 consecutive patients with short and long segment Barrett’s esophagus, and 10 control subjects without organic esophagogastric diseases were enrolled. Biopsy samples of Barrett’s mucosa stained or not stained with methylene blue applied endoscopically were used for histological evaluation and Western blot analysis of EGF receptor, erbB2 and erbB3 proteins. Results: Mean length of Barrett’s esophagus was 2.6 cm (range 1-8 cm) and all tissue samples from methylene blue stained Barretts mucosa consisted of non dysplastic SCE. In the Barretts group, Western blot analysis showed that EGF receptor and erbB2 were equally and strongly expressed in SCE and squamous epithelium; in contrast, erbB3 expression in SCE was considerably weaker. In control subjects, all proteins showed strong expression for all samples. Immunohistochemical analysis of SCE in Barretts esophagus showed positive EGF receptor and erbB2 expression, and no erbB3 expression. Conclusions: ErbB2 is strongly expressed in both non dysplastic SCE and squamous epithelium, whereas erbB3 expression is essentially limited to the squamous epithelium.
基金Project supported by the Natural Science Foundation of Inner Mongolia Autonomous Region(Nos.2019LH08042 and 2018MS08050)the Natural Science Foundation of Baotou Medical College(No.BYJJ-YF-2018024),China。
文摘Objective:To determine the characteristics of postprandial proximal gastric acid pockets(PPGAPs)and their association with gastroesophageal acid reflux in patients with Barrett’s esophagus(BE).Methods:Fifteen patients with BE(defined by columnar lined esophagus of≥1 cm)and 15 healthy individuals that were matched for age,gender,and body mass index,were recruited.The fasting intragastric p H and the appearance time,length,lowest p H,and mean p H of the PPGAP were determined using a single p H electrode pull-through experiment.For BE patients,a gastroesophageal reflux disease questionnaire(Gerd Q)was completed and esophageal 24-h p H monitoring was carried out.Results:The PPGAP was significantly longer(5(3,5)cm vs.2(1,2)cm)and the lowest p H(1.1(0.8,1.5)vs.1.6(1.4,1.9))was significantly lower in patients with short-segment BE than in healthy individuals.The PPGAP started to appear proximally from the gastroesophageal p H step-up point to the esophageal lumen.The acidity of the PPGAP was higher in the distal segment than in the proximal segment.In short-segment BE patients,there were significant correlations between the acidity and the appearance time and length of the PPGAP.The length and acidity of the PPGAP were positively associated with gastroesophageal acid reflux episodes.The acidity of the PPGAP was associated with the De Meester scores,the Gerd Q scores,and the fasting intragastric p H.Conclusions:In patients with short-segment BE,a PPGAP is commonly seen.Its length and acidity of PPGAP are associated with gastroesophageal acid reflux,the De Meester score,and the Gerd Q score in patients with short-segment BE.
