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目的探讨内镜下拟诊为Barrett食管(BE)患者的临床症状、内镜下表现类型和病理特征之间的关系。方法对184例内镜下拟诊为BE的患者进行临床症状评估,HE染色行病理组织学分析。并对临床症状、内镜下表现类型及病理特征之间的关系进行相关分析。结果内镜下拟诊184例BE患者,反酸33例次,反食7例次,烧心23例次,胸骨后疼痛13例次,上腹痛70例次,上腹胀38例次,其中10例患者有食管外症状(咳嗽、咽炎等);37例无明显症状。内镜表现类型岛型128例,环周型43例,舌型13例。活检证实有柱状上皮化生88例(占47.8%),其中有46例可见肠上皮化生,发现1例不典型增生。病理确诊的46例肠化BE和42例非肠化BE患者的反酸发生率明显高于非BE患者,其他临床症状比较无明显差异;内镜下拟诊的3种类型的BE患者临床主要症状比较无明显差异;内镜表现为环周型、岛型和舌型BE的柱状上皮化生和肠化生的检出率无明显差异。结论(1)病理确诊的BE患者反酸的发生率明显高于非BE患者。(2)BE患者内镜表现类型与症状无关。(3)内镜表现以岛状多见,柱状上皮化生和肠上皮化生在3型BE中检出率无差异。
Objective To investigate the relationship between clinical symptoms, endoscopic findings and pathological features of patients with Barrett’s esophagus (BE) under endoscopy. Methods The clinical symptoms of 184 patients undergoing endoscopy with suspected BE were evaluated, and histopathological analysis was performed by HE staining. The correlations between clinical symptoms, endoscopic findings and pathological features were analyzed. Results 184 patients with BE under endoscopy, 33 cases of acid reflux, 7 cases of anti-food, 23 cases of heartburn, 13 cases of post-sternal pain, 70 cases of upper abdominal pain, abdominal distension 38 cases, of which 10 cases Patients with esophageal symptoms (cough, pharyngitis, etc.); 37 cases no obvious symptoms. Endoscopic performance of the island type in 128 cases, 43 cases of perineal, tongue 13 cases. Biopsy confirmed that there were 88 cases of columnar epithelial metaplasia (47.8%), of which 46 cases showed intestinal metaplasia, found 1 case of atypical hyperplasia. The pathological diagnosis of 46 cases of intestinal BE and 42 cases of non-bowel BE patients with acid reflux rate was significantly higher than non-BE patients, other clinical symptoms were no significant difference; endoscopic biopsy of the three types of BE patients clinically major There was no significant difference in symptoms between the two groups. There was no significant difference in the detection rate of peritoneal metaplasia and intestinal metaplasia between endoscopic and peripheral BE. Conclusions (1) The incidence of acid reflux in pathologically confirmed BE patients is significantly higher than that in non-BE patients. (2) BE patients endoscopic manifestations type and symptoms have nothing to do. (3) Endoscopic findings were more common in island shape. There was no difference in the detection rate of columnar epithelial metaplasia and intestinal metaplasia in type 3 BE.