江苏地区Barrett’s食管患病率的内镜研究

目的探讨江苏地区接受内镜检查的人群中Barrett’s食管（BE）患病率及其变化趋势，以及同期同人群中食管腺癌的患病情况。方法以我院近4年接受内镜检查的患者为研究对象，对内镜疑诊的BE患者取活检，病理标本见到真性杯状细胞确诊为BE。分别研究4年间BE的总体患病率、各年度病例患病率及各年龄组患病率，同时研究BE的内镜下形态和同期食管腺癌的患病情况。结果上消化道内镜检查的69544例中，共检出BE105例，BE的总体患病率为1．51‰（95％CI1．27‰～1．75‰），其中男性和女性分别为55例及50例，两者在平均年龄和患病率间均无差异。近四年的年度病例患病率分别为2．15‰、1．23‰、1．41‰及1．39‰，各组间差异无显著性（P=0．18，X2=4．92）。随着年龄增长，BE的患病率呈逐渐增加的趋势，且各个年龄组间患病率差异有显著性（X2=6．07，P〈0．01）。除典型的内镜下表现外，部分BE患者可表现为食管炎、食管溃疡等。BE的内镜下形态以岛形最多见（51．35％），舌形次之（35．14％），全周形最少（13．51％）。食管腺癌占同期所有食管癌的比例仅为4．68％，且近四年该比例并未明显升高。结论近4年江苏地区所有接受上消化道内镜检查者中BE总体患病率约为1．51‰，该比例在过去四年间并没有明显升高，但随着年龄增长其患病率逐渐增加。食管腺癌占所有食管癌的比例仍很低且相对稳定。

Endoscopic Study of Prevalence of Barrett's Esophagus in Jiangsu

Objective To detect the prevalence and tendency of Barrettes esophagus （BE）in Jiangsu province population who undertook upper gastrointestinal endoscopy and to detect the homoehronous prevalence of esophageal adenocarcinoma. Methods Patients who took upper gastrointestinal endoscopy in our endoscopic center during the past four years were selected as the studied subjects, biopsies were taken from the endoscopic suspected BE patients and histologically indicated real goblet cells were diagnosed as BE. The general prevalence, annually prevalence and different age grade prevalence were studied. The endoscopic features of BE and the homochronous prevalence of esophageal adenocarcinoma were studied. Results During the past four years,69,544 patients received upper gastrointestinal endoscopy and 105 cases were diagnosed as BE. The general prevalence was 1.51‰（95% CI 1.27‰- 1.75‰）. Among the 105 BE patients, there were 55 male and 50 female patients. The average age and prevalence between the two gender did not show significant difference. The annually prevalence during the past four years were 2. 15‰, 1. 23‰, 1.41‰ and 1.39%0 respectively （P = 0.18, X2 = 4.92 ）. The prevalence increased with aging and in different age grades the prevalence indicated significant difference （ X2 = 6.07, P 〈 0.01 ）. Esophagitis and esophageal ulcer maybe the endoscopic features in some BE patients. Island - like is the most common then tongue - like and circum- ferential is the least among the three endoscopic features of BE. The proportion of esophageal adenocarcinoma in total esophageal carcinoma was only 4.68% and the proportion was stable in the past four years. Conclusion The general prevalence of BE in Jiangsu population who received upper gastrointestinal endoscopy during the past four years was about 1.51‰ and it did not increase during the past four years, however, it increased with aging. The proportion of esophageal adenocarcinoma was rarely low and stable in total esophageal carcinoma.