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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 explore the similarities and differences between Barrett’s endoscopic and pathological features of long and short segments. Methods Retrospective analysis of 128 cases of Barrett’s esophagus diagnosed by endoscopy and pathology, of which 40 cases of long segment of Barrett’s esophagus (LSBE), 88 cases of short segment Barrett’s esophagus (SSBE), focusing on the two age distribution, gender, Gastroscope performance and pathological diagnosis similarities and differences. Data line t test and u test. Results There was no difference in age distribution and sex composition between LSBE group and SSBE group (P> 0.05). Gastroscopy LSBE group most common in the whole week, accounting for 62.5% SSBE group island most common, accounting for 85.2%. The incidence of LSBE group specific intestinal metaplasia was significantly higher than SSBE group (47.5% vs 14.8%, P <0.01). In specific intestinal metaplasia, the incidence of mild, moderate and severe atypical hyperplasia (15.0%, 12.5%, 5.0%) in LSBE group was significantly lower than that in SSBE group (4.5%, 3.4 %, 0.0%), the difference was also statistically significant (P <0.05). Conclusions LSBE is more likely to have atypical hyperplasia than SSBE. The importance of gastroscopy combined with pathological diagnosis should be fully understood.