Barrett's Esophagus and associations with esophageal mucosal Injuries

Authors

DOI:

https://doi.org/10.33448/rsd-v11i5.28642

Keywords:

Barrett's Esophagus; Mucosal Lesions; Metaplasia; Esophagitis.

Abstract

Introduction: Columnar epithelium in the distal esophagus and biopsies with intestinal metaplasia define Barrett's esophagus (EB). The objective was to identify the association of EB and esophageal mucosa lesions in histopathological reports. Methods: a retrospective and cross-sectional study with 1953 reports of esophageal mucosa. Results: 1953 biopsies of esophageal mucosa lesions were analyzed. We identified 133 (6.8%) of Barrett's esophagus, 151 (7.7%) with H.pylori and of these, 17 (11.3%) (p =0.041) were associated with Barrett's esophagus. The mean age group was 52 years old (IQR 42.5-62.5), male prevalence (63.2%). Lesions associated with EB: metaplasia 23 (17.3%) (p=0.004); dysplasia 8 (6%) (p<0.001), and 8 (100%) had low-grade dysplasia (p<0.001) and esophagitis with 34 (25.6%) reports, 33 (97%) of the chronic type . No association with malignancy was identified. As for the gross and adjusted relative risks, the following were significant: age (RR: 1.03 (95%CI: 1.02-1.04)) and RRa (95%CI) 1.03 (1.02-1.03), male sex, RR (95%CI) 1.76 (1.25-2.48) and RRa (95%CI) 1.03 (1.02-1.03) and dysplasia. Esophagitis, metaplasia and eosinophilic esophagitis were not likely to be at risk. There was a high probability of carcinogenic exposure regarding dysplasia (p=0.002) RR 5.83 (3.29-10.32), RRa 2.63 (1.45-4.78). Esophagitis was diagnosed in 1,416 reports of the total sample. When correlating with metaplasia, it was statistically significant (RR: 1.27; 95%CI: 1.14-1.42). Conclusion: male patients over 50 years of age with dysplasia and absence of esophagitis had a higher risk of Barrett's esophagus. Those who had metaplasia and eosinophils >=15 eos/AGC without lesions glycogenic acanthosis and polyps were at risk for esophagitis. The presence of metaplasia alone did not represent a risk factor for EB, although esophagitis seems to represent a greater risk for the development of metaplasia. Low-grade dysplasia was associated with a high carcinogenic probability.

References

Artifon, E. L. A., Otoch, J. P., Castño, R., & Vilela, T. (2015). Ensino da Endoscopia com modelos Ex Vivo e simulador virtual. Endoscopia digestiva oncológica: diagnóstica e terapêutica. Rio de Janeiro: Revinte

Banki, F., Demeester, S. R., Mason, R. J., Campos, G., Hagen, J. A., Peters, J. H., Bremner, C. G., & Demeester, T. R. (2005). Barrett's esophagus in females: a comparative analysis of risk factors in females and males. The American journal of gastroenterology, 100(3), 560–567. https://doi.org/10.1111/j.1572-0241.2005.40962.x

Bujanda, D. E., & Hachem, C. (2018). Barrett's Esophagus. Missouri medicine, 115(3), 211–213.

Cook, M. B., Wild, C. P., & Forman, D. (2005). A systematic review and meta-analysis of the sex ratio for Barrett's esophagus, erosive reflux disease, and nonerosive reflux disease. American journal of epidemiology, 162(11), 1050–1061. https://doi.org/10.1093/aje/kwi325

Degiovani, M., Ribas, C. A. P. M., Czeczko, N. G., Parada, A. A., Fronchetti, J. de A., & Malafaia, O. (2019). Existe relação entre o helicobacter pylori e metaplasia intestinal nas epitelizações colunares curtas até 10 MM no esôfago distal? ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 32. https://www.scielo.br/j/abcd/a/Jzwq56NC68yPnmmxqynQRpD/abstract/?lang=pt

Du, Y.L., Duan, R.Q. & Duan, L.P. Helicobacter pylori infection is associated with reduced risk of Barrett’s esophagus: a meta-analysis and systematic review. BMC Gastroenterol 21, 459 (2021). https://doi.org/10.1186/s12876-021-02036-5

Fabian, T., & Leung, A. (2021). Epidemiology of Barrett's Esophagus and Esophageal Carcinoma. The Surgical clinics of North America, 101(3), 381–389. https://doi.org/10.1016/j.suc.2021.03.001

Frugis, S., Czeczko, N. G., Malafaia, O., Parada, A. A., Poletti, P. B., Secchi, T. F., Degiovani, M., Rampanazzo-Neto, A., & D´agostino, M. D. (2016). Prevalência do helicobacter pylori há dez anos comparada com a atual em pacientes submetidos à endoscopia digestiva alta. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 29, 151–154. https://www.scielo.br/j/abcd/a/zH4sMCmpLvW5wBL5xt4Wd7G/abstract/?lang=pt

Kountouras, J., Doulberis, M., Papaefthymiou, A., Polyzos, S. A., Vardaka, E., Tzivras, D., Dardiotis, E., Deretzi, G., Giartza-Taxidou, E., Grigoriadis, S., & Katsinelos, P. (2019). A perspective on risk factors for esophageal adenocarcinoma: emphasis on Helicobacter pylori infection. Annals of the New York Academy of Sciences, 1452(1), 12–17. https://doi.org/10.1111/nyas.14168

Iyer, P. G., & Kaul, V. (2019). Barrett Esophagus. Mayo Clinic proceedings, 94(9), 1888–1901. https://doi.org/10.1016/j.mayocp.2019.01.032

Marques de Sá, I., Marcos, P., Sharma, P., & Dinis-Ribeiro, M. (2020). The global prevalence of Barrett’s esophagus: A systematic review of the published literature. United European Gastroenterology Journal, 8(9), 1086–1105. https://doi.org/10.1177/2050640620939376

Na, H. K., Lee, J. H., Park, S. J., Park, H. J., Kim, S. O., Ahn, J. Y., Kim, D. H., Jung, K. W., Choi, K. D., Song, H. J., Lee, G. H., & Jung, H. Y. (2020). Effect of Helicobacter pylori eradication on reflux esophagitis and GERD symptoms after endoscopic resection of gastric neoplasm: a single-center prospective study. BMC gastroenterology, 20(1), 123. https://doi.org/10.1186/s12876-020-01276-1

Passos M. (2007). Infecção pelo Helicobacter pylori: prevalência e associação com lesões gástricas [Helicobacter pylori infection: prevalence and association with gastric lesions]. Arquivos de gastroenterologia, 44(2), 91–92. https://doi.org/10.1590/s0004-28032007000200001

Que, J., Garman, K. S., Souza, R. F., & Spechler, S. J. (2019). Pathogenesis and Cells of Origin of Barrett's Esophagus. Gastroenterology, 157(2), 349–364.e1. https://doi.org/10.1053/j.gastro.2019.03.072

Ronkainen, J., Talley, N. J., Storskrubb, T., Johansson, S. E., Lind, T., Vieth, M., Agréus, L., & Aro, P. (2011). Erosive esophagitis is a risk factor for Barrett's esophagus: a community-based endoscopic follow-up study. The American journal of gastroenterology, 106(11), 1946–1952. https://doi.org/10.1038/ajg.2011.326

Silva, P. H. A.; Fernandes, F. A. L.; Pontes, K. R. S.; Araujo, M. K.M.; Souza, D. L. B.; Correia, L.P.M.P. Prevalência do Esôfago de Barrett em pacientes submetidos à endoscopia digestiva alta em hospital universitário - Natal - RN. GED gastroenterol. endosc. dig. 2015: 34(2):47-53.

Souza R. F. (2017). Reflux esophagitis and its role in the pathogenesis of Barrett's metaplasia. Journal of gastroenterology, 52(7), 767–776. https://doi.org/10.1007/s00535-017-1342-1

Schulz, M. K., Biancardi, M. R., Fernandes, D., Almeida, L. Y. de, Bufalino, A., & Leon, J. E. (2018). Glycogenic acanthosis on mouth clinically present as white plaque. RGO, Rev Gaúch Odontol. 66 (3), 274-277.

Sharma, N., & Ho, K. Y. (2016). Risk Factors for Barrett's Oesophagus. Gastrointestinal tumors, 3(2), 103–108. https://doi.org/10.1159/000445349

Torres, T. P., Caponi, L. G. F., Stafin, I., de Araujo, J. N., & Guedes, V. R. (2014). Critérios Morfológicos no Esôfago de Barrett. HU Revista, 39(1 e 2). Recuperado de https://periodicos.ufjf.br/index.php/hurevista/article/view/2062

Vinit, C., Dieme, A., Courbage, S., Dehaine, C., Dufeu, C. M., Jacquemot, S., Lajus, M., Montigny, L., Payen, E., Yang, D. D., & Dupont, C. (2019). Eosinophilic esophagitis: Pathophysiology, diagnosis, and management. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 26(3), 182–190. https://doi.org/10.1016/j.arcped.2019.02.005

Yılmaz N. The relationship between reflux symptoms and glycogenic acanthosis lesions of the oesophagus. Prz Gastroenterol. 2020;15(1):39-43. doi:10.5114/pg.2019.85248

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Published

17/04/2022

How to Cite

LUCCHESI, C. B. .; MORAIS , V. M. O.; TRINDADE, Y. T. D.; MACEDO, V. R. S.; MOURA, E. R.; MELO, D. J. de S.; MOREIRA, L. G.; BARRETO, Íkaro D. de C.; SILVA, D. F. da; TRINDADE, L. M. D. F. Barrett’s Esophagus and associations with esophageal mucosal Injuries. Research, Society and Development, [S. l.], v. 11, n. 5, p. e58811528642, 2022. DOI: 10.33448/rsd-v11i5.28642. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/28642. Acesso em: 20 apr. 2024.

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Vol. 11 No. 5

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Health Sciences

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Copyright (c) 2022 Carolina Basílio Lucchesi; Vanessa Maria Oliveira Morais ; Yasmin Tourinho Delmondes Trindade; Victor Ravel Santos Macedo; Elomar Rezende Moura; Durval José de Santana Melo; Larissa Gonçalves Moreira; Íkaro Daniel de Carvalho Barreto; Décio Fragata da Silva; Leda Maria Delmondes Freitas Trindade

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