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Clinical characteristics of young patients with early Barrett’s neoplasia

World Journal of Gastroenterology 2019年第24期25卷 3069-3078页

作者： Yugo Iwaya Yuto Shimamura Kenichi Goda Enrique Rodríguez de Santiago John Gerard Coneys Jeffrey D Mosko Gabor Kandel paul kortan Gary May Norman Marcon Christopher Teshima Advanced Therapeutic Endoscopy Centre St Michael’s HospitalUniversity of TorontoToronto M5B 1W8OntarioCanada Department of Gastroenterology Dokkyo Medical UniversityTochigi 321-0293Japan Department of Gastroenterology Ramón y Cajal university hospitalMadrid 28034Spain

BACKGROUND Esophageal adenocarcinoma(EAC)and high-grade dysplasia(HGD)may appear in young patients with Barrett's esophagus(BE).However,characteristics of Barrett's-related neoplasia in this younger population remain *** To identify clinical characteristics that differ between young and old patients with early-stage Barrett's-related *** We conducted a retrospective analysis of a prospectively maintained database comprised of consecutive patients with early-stage EAC(pT1)and HGD at a tertiary-referral center between 2001 and *** characteristics,drug and risk factor exposures,clinicopathological staging of EAC/HGD and treatment outcomes[complete eradication of neoplasia(CE-N),complete eradication of intestinal metaplasia(CE-IM),recurrence of neoplasia and recurrence of intestinal metaplasia]were *** analyses were performed to identify factors that differed significantly between older and younger(≤50 years)*** We identified 450 patients with T1 EAC and HGD(74%and 26%,respectively);45(10%)were≤50 *** to the older group,young patients were more likely to present with ongoing gastroesophageal reflux disease(GERD)symptoms(55%vs 38%,P=0.04)and to be obese(body mass index>30,48%vs 32%,P=0.04).Multivariate logistic regression analysis showed that young patients were significantly more likely to have ongoing GERD symptoms[odds ratio(OR)2.00,95%confidence interval(CI)1.04-3.85,P=0.04]and to be obese(OR 2.06,95%CI 1.07-3.98,P=0.03)whereas the young group was less likely to have a smoking history(OR 0.39,95%CI 0.20-0.75,P50 years of age,younger patients should be considered for screening endoscopy if they suffer from obesity and GERD symptoms.

关键词： Barrett's Esophagus Gastroesophageal reflux disease Obesity Esophageal adenocarcinoma High-grade dysplasia Guideline Young patient

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