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Risk Factors for the Progression of Endoscopic Barrett’s Epithelium in Japan: A Multivariate Analysis Based on the Prague C & M Criteria

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Abstract

Purpose To determine the prevalence and progression of Barrett’s epithelium and associated risk factors in Japan. Methods The study population comprised 869 cases. Endoscopic Barrett’s epithelium was diagnosed based on the Prague C & M Criteria. The correlations of clinical factors with the prevalence and progression of endoscopic Barrett’s epithelium were examined. Results Endoscopic Barrett’s epithelium was diagnosed in 374 cases (43%), in the majority of which the diagnosis was short-segment Barrett’s esophagus. The progression of Barrett’s epithelium was identified in 47 cases. In univariate and multiple logistic regression analyses, aging, smoking habit, and erosive esophagitis were significantly associated with the prevalence of Barrett’s epithelium, whereas aging and erosive esophagitis, especially severe erosive esophagitis, were significant contributing factors to the progression of Barrett’s epithelium. Conclusions Forty-three percent of the total study population was diagnosed as having endoscopic Barrett’s epithelium. During the follow-up period, 12.6% of the cases with Barrett’s epithelium exhibited progression which was associated with aging and severe erosive esophagitis.

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References

  1. Mann NS, Tsai MF, Nair PK. Barrett’s esophagus in patients with symptomatic reflux esophagitis. Am J Gastroenterol. 1989;84:1494–1496.

    PubMed  CAS  Google Scholar 

  2. Winters C Jr, Spurling TJ, Chobanian SJ, Curtis DJ, Esposito RL, Hacker JF 3rd, et al. Barrett’s esophagus. A prevalent, occult complication of gastroesophageal reflux disease. Gastroenterology. 1987;92:118–124.

    PubMed  Google Scholar 

  3. Blot WJ, McLaughlin JK. The changing epidemiology of esophageal cancer. Semin Oncol. 1999;26:2–8.

    PubMed  CAS  Google Scholar 

  4. Botterweck AA, Schouten LJ, Volovics A, Dorant E, van den Brandt PA. Trends in incidence of adenocarcinoma of the oesophagus and gastric cardia in ten European countries. Int J Epidemiol. 2000;29:645–654. doi:10.1093/ije/29.4.645.

    Article  PubMed  CAS  Google Scholar 

  5. Powell J, McConkey CC, Gillison EW, Spychal RT. Continuing rising trend in oesophageal adenocarcinoma. Int J Cancer. 2002;102:422–427. doi:10.1002/ijc.10721.

    Article  PubMed  CAS  Google Scholar 

  6. Hongo M, Shoji T. Epidemiology of reflux disease and CLE in East Asia. J Gastroenterol. 2003;38:25–30. doi: 10.1007/s00535-003-1208-6.

    Article  PubMed  Google Scholar 

  7. Harle IA, Finley RJ, Belsheim M, Bondy DC, Booth M, Lloyd D, et al. Management of adenocarcinoma in a columnar-lined esophagus. Ann Thorac Surg. 1985;40:330–336.

    PubMed  CAS  Google Scholar 

  8. Ransom JM, Patel GK, Clift SA, Womble NE, Read RC. Extended and limited types of Barrett’s esophagus in the adult. Ann Thorac Surg. 1982;33:19–27.

    PubMed  CAS  Google Scholar 

  9. Menke-Pluymers MB, Hop WC, Dees J, van Blankenstein M, Tilanus HW. Risk factors for the development of an adenocarcinoma in columnar-lined (Barrett) esophagus. The Rotterdam Esophageal Tumor Study Group. Cancer. 1993;72:1155–1158. doi :10.1002/1097-0142(19930815)72:4<1155::AID-CNCR2820720404>3.0.CO;2-C.

    Article  PubMed  CAS  Google Scholar 

  10. Sharma P, Dent J, Armstrong D, Bergman JJ, Gossner L, Hoshihara Y, et al. The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria. Gastroenterology. 2006;131:1392–1399. doi:10.1053/j.gastro.2006.08.032.

    Article  PubMed  Google Scholar 

  11. Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;3:87–97.

    Article  Google Scholar 

  12. Miki K, Ichinose M, Shimizu A, Huang SC, Oka H, Furihata C, et al. Serum pepsinogens as a screening test of extensive chronic gastritis. Gastroenterol Jpn. 1987;22:133–141.

    PubMed  CAS  Google Scholar 

  13. Armstrong D, Bennett JR, Blum AL, Dent J, De Dombal FT, Galmiche JP, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111:85–92. doi:10.1053/gast.1996.v111.pm8698230.

    Article  PubMed  CAS  Google Scholar 

  14. Hoshihara Y, Kogure T, Yamamoto Y. Diagnosis of short segment Barrett’s esophagus. Stom Intest. 1999;34:133–139. (In Japanese with English abstract).

    Google Scholar 

  15. Sharma P, Morales TG, Sampliner RE. Short segment Barrett’s esophagus—the need for standardization of the definition and of endoscopic criteria. Am J Gastroenterol. 1998;93:1033–1066.

    PubMed  CAS  Google Scholar 

  16. Hamilton SR, Smith RR. The relationship between columnar epithelial dysplasia and invasive adenocarcinoma arising in Barrett’s esophagus. Am J Clin Pathol. 1987;87:301–312.

    PubMed  CAS  Google Scholar 

  17. Conio M, Filiberti R, Blanchi S, Ferraris R, Marchi S, Ravelli P, et al. Gruppo Operativo per lo Studio delle Precancerosi Esofagee (GOSPE). Risk factors for Barrett’s esophagus: a case–control study. Int J Cancer. 2002;97:225–229. doi:10.1002/ijc.1583.

    Article  PubMed  CAS  Google Scholar 

  18. Ronkainen J, Aro P, Storskrubb T, Johansson SE, Lind T, Bolling-Sternevald E, et al. Prevalence of Barrett’s esophagus in the general population: an endoscopic study. Gastroenterology. 2005;129:1825–1831. doi:10.1053/j.gastro.2005.08.053.

    Article  PubMed  Google Scholar 

  19. Oberg S, DeMeester TR, Peters JH, Hagen JA, Nigro JJ, DeMeester SR, et al. The extent of Barrett’s esophagus depends on the status of the lower esophageal sphincter and the degree of esophageal acid exposure. J Thorac Cardiovasc Surg. 1999;117:572–580. doi:10.1016/S0022-5223(99)70337-5.

    Article  PubMed  CAS  Google Scholar 

  20. Wakelin DE, Al-Mutawa T, Wendel C, Green C, Garewal HS, Fass R. A predictive model for length of Barrett’s esophagus with hiatal hernia length and duration of esophageal acid exposure. Gastrointest Endosc. 2003;58:350–355. doi:10.1067/S0016-5107(03)00007-5.

    Article  PubMed  Google Scholar 

  21. Avidan B, Sonnenberg A, Schnell TG, Sontag SJ. Hiatal hernia and acid reflux frequency predict presence and length of Barrett’s esophagus. Dig Dis Sci. 2002;47:256–264. doi:10.1023/A:1013797417170.

    Article  PubMed  Google Scholar 

  22. Caygill CP, Johnston DA, Lopez M, Johnston BJ, Watson A, Reed PI, et al. Lifestyle factors and Barrett’s esophagus. Am J Gastroenterol. 2002;97:1328–1331. doi:10.1111/j.1572-0241.2002.05768.x.

    Article  PubMed  Google Scholar 

  23. Cameron AJ, Lomboy CT. Barrett’s esophagus: age, prevalence, and extent of columnar epithelium. Gastroenterology. 1992;103:1241–1245.

    PubMed  CAS  Google Scholar 

  24. Wu JC, Mui LM, Cheung CM, Chan Y, Sung JJ. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007;132:883–889. doi:10.1053/j.gastro.2006.12.032.

    Article  PubMed  Google Scholar 

  25. Kinoshita Y, Kawanami C, Kishi K, Nakata H, Seino Y, Chiba T. Helicobacter pylori independent chronological change in gastric acid secretion in the Japanese. Gut. 1997;41:452–458.

    Article  PubMed  CAS  Google Scholar 

  26. Food and Agriculture Organization of the United Nations (FAO) FAOSTAT nutrition data. Food balance sheet. Home page at: http://www.fao.org/.

  27. Ollyo JB, Monnier P, Fontolliet C, Savary M. The natural history, prevalence and incidence of reflux esophagitis. Gullet. 1993;3(Suppl):3–10.

    Google Scholar 

  28. Amano K, Adachi K, Katsube T, Watanabe M, Kinoshita Y. Role of hiatus hernia and gastric mucosal atrophy in the development of reflux esophagitis in the elderly. J Gastroenterol Hepatol. 2001;16:132–136. doi:10.1046/j.1440-1746.2001.02408.x.

    Article  PubMed  CAS  Google Scholar 

  29. Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991;265:1287–1289. doi:10.1001/jama.265.10.1287.

    Article  PubMed  CAS  Google Scholar 

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Akiyama, T., Inamori, M., Akimoto, K. et al. Risk Factors for the Progression of Endoscopic Barrett’s Epithelium in Japan: A Multivariate Analysis Based on the Prague C & M Criteria. Dig Dis Sci 54, 1702–1707 (2009). https://doi.org/10.1007/s10620-008-0537-y

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