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AJG: 贲门失弛缓症患者发生食管鳞状细胞癌和腺癌的风险较高

2021-02-22 MedSci原创 MedSci原创

贲门失弛缓症一种罕见的食道疾病,其特征是食管缺乏蠕动,食管下括约肌(LES)的松弛受损,妨碍了正常的食管排空。

      贲门失弛缓症一种罕见的食道疾病,其特征是食管缺乏蠕动,食管下括约肌(LES)的松弛受损,妨碍了正常的食管排空。膨大的食道导致积水和食物滞留,由此细菌过度生长和化学刺激会导致慢性食管粘膜发炎,会导致潜在发展发育不良和食管鳞状细胞癌的发生。目前还缺乏缺乏关于评估贲门失弛缓患者食管癌相对风险和发生率的流行病学研究。因此,本项研究旨在进行了一项长期的前瞻性队列研究,以评估这些患者中食管鳞状细胞癌和食道腺癌的风险。

 

 

      研究人员收集了在1973年至2018年之间发生原发性门失弛缓症患者的临床数据,所有患者均接受了相同的治疗方案,包括内镜和食管活检。当与性别和年龄相匹配的普通人群进行配比后进行了发病率的分析,研究人员使用标准化发生率(SIR)来估计门失弛缓患者食道癌的相对风险。

 

 

      本项研究共纳入566例贲门失弛缓患者(46%的男性,平均诊断年龄:48.1岁),平均随访时间为15.5年。总体而言,有20例患者(15名男性)发展为食道癌,其中15例为鳞状细胞癌,5例腺癌。食道癌的风险显着高于普通人群(SIR 104.2,95%CI 63.7–161),鳞状细胞癌(SIR 126.9,95%CI 71.0–209.3)和腺癌(SIR 110.2,95% CI 35.8–257.2)。男性发生癌症的风险高于女性(P<0.001)

 

 

      本项研究通过大样本人群调查后发现贲门失弛缓症患者罹患食管鳞状细胞癌和腺癌的风险较高,男性中这样的风险更高。

 

 

 

原始出处:

Zagari, Rocco Maurizio. Et al. Risk of Squamous Cell Carcinoma and Adenocarcinoma of the Esophagus in Patients With Achalasia: A Long-Term Prospective Cohort Study in Italy. The American Journal of Gastroenterology.2021.

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    2022-02-06 zhouqu_8
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    2021-07-16 minzju5052
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    2021-02-24 zhouqu_8
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