Système gastro-intestinal et digestif

Abstrait

The Histopathological Correlation with Clinical and Endoscopic Evidence in Patients with Barrett'S Esophagus

Zaim Gashi, Ljube Ivkovski, Ragip Shabani and Aurora Bakalli

Barrett’s esophagus (BE) is a condition in which the normal squamous epithelium of the esophagus is replaced with metaplastic intestinal-type epithelium. Many factors that appear to be risk factors for the presence of BE include obesity, the presence of hiatal hernia, and interestingly, the absence of Helicobacter pylori infection. The diagnosis of Barrett’s esophagus is made by endoscopy and confirmed by histology The aim of this study was to determine the histological correlation with clinical end endoscopical appearance in this patients with BE. Methods: 58 patients with endoscopically diagnosed and histopathologically verified BE were included in this prospective study. We analysed predictive factors such as: age, sex, obesity, alcohol consumption and smoking, reflux symptom duration in this patients, prevalence of short and long segment of BE, and the presence of hiatal hernia. After endoscopic examination of these patients, the presence of BE was verified with histopathological examination to determine the correlation between the endoscope diagnosis and histopathologic outcome in patients with BE. Results: Among 58 subjects, 35 (60%) were males and 23 (40%) were females, with mean age of 50.4 ±3.28 years. Obesity was present in 32/58 patients (55.2%). 39 patients from 58 patients were smokers (67.2%). Symptom duration in these patients was approximately 8.9±1.90 years. From total number of patients, 35 were with short segment (60.3%), the rest (23 patients) were with long segment of Barrett’s esophagus (39.7%). Hiatal hernia was present in 64% of patients, 40 of 58 patients diagnosed with Barrett’s esophagus (69%) also had hiatal hernia, of which 32/40 (80%) were with LSBE, and 8/40 patients (20%) were with SSBE. Conclusions: The important risk factors for appearance of BE in GERD patients were male sex, middle age, obesity, hiatal hernia, smoking and alcohol consumption. The prevalence of infection with H. Pylori in patients with BE was lower and this may predict a protective role of this microorganism. Diagnostic accuracy of Barrett’s esophagus is significantly greater in patients with LSBE than in those with SSBE (94.3% vs 43.5%) and p <0.05).