长、短节段Barrett食管胃镜表现与病理特征对比分析  

Comparisons of endoscopic and pathological characteristics between long and short segment Barrett's esophagus

作　　者：周晶[1] 沈志祥[1] 罗和生[1] 沈磊[1] 刘军[1] 杨咏梅[1] 邹莉萍[1] 

机构地区：[1]武汉大学人民医院消化内科,430060

出　　处：《中华消化杂志》2006年第7期440-443,共4页Chinese Journal of Digestion

摘　　要：目的探讨长、短节段Barrett食管胃镜表现和病理特征的异同。方法回顾分析128例经胃镜和病理学诊断确诊的Barrett食管,其中长节段Barrett食管(LSBE)40例,短节段Barrett食管(SSBE)88例,重点分析两者在年龄分布、性别构成、胃镜表现及病理诊断的异同点。数据行t检验及u检验。结果LSBE组与SSBE组在年龄分布、性别构成上无差异(P＞0．05)。胃镜下LSBE组以全周型最多见,占62．5％SSBE组以岛型最多见,占85．2％。LSBE组特异型肠上皮化生的发生率比SSBE组明显增高,差异有统计学意义(47．5％比14．8％,P＜0．01)。在特异型肠上皮化生中,LSBE组轻、中、重度不典型增生的发生率(15．0％,12．5％,5．0％)较SSBE组(4．5％,3．4％,0．0％)高,差异也具有统计学意义(P值均＜0．05)。结论LSBE较SSBE更易发生不典型增生,应充分认识胃镜表现结合病理诊断的重要性。Objective To investigate the similarities and differences of endoscopic and pathological characteristics between long and short segment Barrett＇s esophagus. Methods One hundred and twenty-eight cases of Barrett＇s esophagus identified both by endoscopy and pathology were enrolled in this retrospective study. Among them, 40 cases were long segment Barrett＇s esophagus （LSBE） and 88 were short segment Barrett＇s esophagus （SSBE）. The age distribution, sex distinction, endoscopic manifestations and pathological changes were assessed. Data were statistically analyzed by t-test or u-test. Results There were no differences in age distribution and sex distinction between LSBE and SSBE groups （P 〉 0.05）. The ring pattern was the most prominent type accounting for 62. 5% in LSBE group. The island pattern was the most prominent type accounting for 85.2% in SSBE group. There were significant differences in the rates of specialized intestinal metaplasia between LSBE and SSBE groups（47.5% vs 14.8%, P〈0.01 ）. Moreover, among the specialized intestinal metaplasia, low grade （15.0% vs 4.5%）, medium grade （12.5% vs 3.4%） and high grade dysplasia （5.0% vs 0.0% ） between LSBE and SSBE groups also had statistical differences （all P〈0.05）. Conclusions LSBE may have more tendency in dysplasia than that of SSBE. We should pay attention to the importance of endoscopic manifestations and pathological diagnosis.

关 键 词：长节段Barrett食管 短节段BARRETT食管 胃镜 病理学 

分 类 号：R571[医药卫生—消化系统] R573[医药卫生—内科学]