The Prevalence of Barrett's Esophagus in Patients with *

巴雷特食管在以下患者中的患病率*

• 批准号: 6804636
• 负责人: BLAIR Anderson JOBE
• 金额: $ 7.55万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6804636
• 关键词: Barretts esophagus; adenocarcinoma; adolescence (12-20); adult human (21+); cancer risk; clinical research; endoscopy; esophagus neoplasm; gastrointestinal epithelium; gastrointestinal sign /symptom; human subject; laryngoscopy; metaplasia; questionnaires; reflux esophagitis

DESCRIPTION (provided by applicant): The incidence of esophageal adenocarcinoma arising from Barrett's metaplasia has increased by 350% since 1970 and at the time of presentation, 50% of patients will have advanced disease with virtually no chance for cure. The prognosis for esophageal adenocarcinoma arising from Barrett's metaplasia is poor: The overall 5-year survival rate is less than 10%. Patients with classic and chronic symptoms of gastroesophageal reflux disease (GERD) undergo endoscopic screening for Barrett's metaplasia. Several retrospective studies have demonstrated an earlier stage of diagnosis and a marked improvement in survival of patients with cancers detected by routine endoscopic surveillance for Barrett's esophagus. In spite of these efforts, the majority of patients who develop esophageal adenocarcinoma are unaware of the presence of Barrett's metaplasia prior to cancer diagnosis. In addition, a large proportion of these patients have never reported symptoms of GERD. These findings suggest that the majority of patients who are at highest risk for the development of esophageal adenocarcinoma are never screened for Barrett's metaplasia. Some investigators have suggested that patients who develop esophageal cancer may not have typical GERD symptoms and therefore are not identified for endoscopic screening. As a result, occult disease progression occurs and advanced cancer is present at the time of diagnosis. Substantial published data support a causal relation between complicated GERD (esophagitis and Barrett's metaplasia) and extraesophageal reflux symptoms. The prevalence of GERD-related esophageal injury in patients with isolated extraesophageal symptoms (i.e., no heartburn or regurgitation) is unknown. The primary aim of this study is to establish that patients with symptoms of extraesophageal reflux who are referred to an otolaryngology clinic have a prevalence of Barrett's metaplasia equivalent to that of a population with GERD symptoms. We will compare the prevalence of biopsy proven Barrett's metaplasia in patients with extraesophageal reflux symptoms with patients who have GERD symptoms and those who do not have GERD symptoms. The two comparison groups will be prospectively accrued through the Clinical Outcomes Research Initiative (CORI) endoscopic database at Oregon Health and Science University and the Portland VA Medical Center. This pilot study will provide needed data to improve risk stratification for esophageal adenocarcinoma and potentially modify the inclusion criteria for routine Barrett's screening. In addition, this study will enhance our understanding of the natural history of esophageal injury in patients with extraesophageal reflux and raise awareness of non-GERD risk factors.

描述（由申请人提供）： 自1970年以来，由Barrett的化学症引起的食管腺癌的发病率增加了350％，在介绍时，50％的患者将患有患者患疾病，几乎没有治愈的机会。由Barrett的化学症引起的食管腺癌的预后很差：总5年生存率小于10％。胃食管反流疾病（GERD）经典和慢性症状的患者接受Barrett Metaplasia的内窥镜检查。一些回顾性研究表明，诊断的较早阶段，并且通过常规内窥镜监测对巴雷特食管检测到的癌症患者的存活率明显提高。尽管做出了这些努力，但大多数出现食管腺癌的患者在癌症诊断之前并不意识到Barrett的Metaplasia存在。此外，这些患者中有很大一部分从未报告过GERD的症状。这些发现表明，大多数患食管腺癌发育风险最高的患者从未被筛选出Barrett的Metaplasia。一些研究人员建议，患食管癌的患者可能没有典型的GERD症状，因此未发现内窥镜检查。结果，诊断时会发生神秘疾病进展，晚期癌症存在。 大量发表的数据支持复杂的GERD（食管炎和Barrett的Metaplasia）与食管外反流症状之间的因果关系。孤立的食管外症状（即没有胃灼热或反流）患者中与GERD相关的食管损伤的患病率尚不清楚。 这项研究的主要目的是确定被称为耳鼻喉科诊所的食管外反流症状的患者的患病率与Barrett的化生相同，相当于患有GERD症状的人群。我们将与患有GERD症状的患者和没有GERD症状的患者进行活检证明的Barrett转换症状的Barrett化生的患病率。这两个比较小组将通过俄勒冈州健康与科学大学和波特兰VA医学中心的临床结果研究计划（CORI）内窥镜数据库进行前瞻性累积。 这项试点研究将提供所需的数据，以改善食道腺癌的风险分层，并有可能修改常规Barrett筛查的纳入标准。此外，这项研究将增强我们对食道外回流患者食管损伤自然史的理解，并提高人们对非GERD危险因素的认识。

项目成果

Unsedated small-caliber upper endoscopy: an emerging diagnostic and therapeutic technology.

无镇静小口径上消化道内窥镜检查：一种新兴的诊断和治疗技术。

• DOI: 10.1177/155335060601300106
• 发表时间: 2006
• 期刊: Surgical innovation
• 影响因子: 1.5
• 作者: Kim,CharlesY;O'Rourke,RobertW;Chang,EugeneY;Jobe,BlairA
• 通讯作者: Jobe,BlairA

EUS characteristics of Nissen fundoplication: normal appearance and mechanisms of failure.

Nissen 胃底折叠术的 EUS 特征：正常外观和失败机制。

• DOI: 10.1016/j.gie.2005.08.044
• 发表时间: 2006
• 期刊: Gastrointestinal endoscopy.
• 作者: Gopal,DeepakV;Chang,EugeneY;Kim,CharlesY;Sandone,Corinne;Pfau,PatrickR;Frick,TerrenceJ;Hunter,JohnG;Kahrilas,PeterJ;Jobe,BlairA
• 通讯作者: Jobe,BlairA