老年人Barrett食管的内镜表现及病理特征分析

Objective To explore the similarities and differences in endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus (BE). Methods Three hundred and seventy-one cases with BE were divided into elderly group (n=254) and nonelderly group (n=117). The detection rate, endoscopic findings and pathological changes were assessed. Results The detection rate of BE was 2.9% in the elderly, and 0. 9% in the non-elderly(χ2 =127.8, P＜0.01). The 112 cases (44.1%) of the elderly had reflux symptoms, and so did 87cases (66.7%) of the non-elderly (χ2 =55.9, P＜0.01). The detection rate of BE in the two groups was increased year by year from 2004 to 2008. The detection rate of ring pattern was significantly higher in elderly group than in non-elderly group (28.7% vs. 10.3%, χ2=14.5, P＜0.01). Nonelderly patients had higher rate of island pattern than elderly patients (59.5% vs. 71.7%, χ2=4.7,P＜0.05). There were significant differences in the rate of specialized intestinal metaplasia between elderly and non-elderly patients (42.1% vs. 27.4%, χ2=6.9, P＜0.01). The difference in low and medium grade intraepithelial neoplasm between the two groups had statistical significance (21.3% vs.11.1%, χ2=4.9, P＜0.05). There were two cases with adenocarcinoma in elderly group, but no case was found in non-elderly group. The detection rate of H. pylori was comparable between elderly group and non-elderly group (35.5% vs. 40.9%, χ2=0.40, P＞0.05). Conclusions The elderly patients have the 3.2 times higher detection rate of BE than non-elderly patients. The detection rates of specialized intestinal metaplasia and intraepithelial neoplasm are higher in elderly group than in nonelderly group.

Comparisons of endoscopic and pathological characteristics between elderly and non-elderly patients with Barrett esophagus