Correlation of oesophageal acid exposure with Barrett's oesophagus length

Fass, Ronnie; Hell, R W; Garewal, Harinder S.; Martinez, Patricia; Pulliam, Gloria; Wendel, Christopher; Sampliner, Richard E.

doi:10.1136/gut.48.3.310

Cited by 134 publications

(97 citation statements)

References 23 publications

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“…5 For example, it was reported that the amount and duration of oesophageal acid exposure correlate well with the length of BE. [6][7] Similarly, the prevalence and size of hiatus hernia is higher among patients with longer segments of BE when compared to subjects with short segment BE or no BE. 5,8 Barrett's oesophagus is an acquired condition and is thought to develop in adulthood as a result of faulty healing of oesophageal mucosa damaged by gastrooesphageal reflux.…”

Section: Introductionmentioning

confidence: 97%

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The length of newly diagnosed Barrett's oesophagus and prior use of acid suppressive therapy

El–Serag

Aguirre

Kuebeler

et al. 2004

Aliment Pharmacol Ther

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Summary Background : The length of Barrett's oesophagus seems to correlate well with indicators of severe gastro‐oesophageal reflux disease. However, it remains unknown whether prior acid suppressive therapy affects the length of newly diagnosed Barrett's oesophagus. Methods : A retrospective analysis of a well‐characterized large cohort of patients with Barrett's oesophagus diagnosed between 1981 and 2000. Aim : To compare the length of Barrett's oesophagus between patients who received acid suppressive therapy prior to their diagnosis to those who did not receive such therapy. Pharmacy records were obtained from Department of the Veterans Affairs computerized records and prospectively collected research records. We further examined the association between prior use of acid suppressive therapy and the length of Barrett's oesophagus in correlation analyses, as well as multivariate linear regression analyses while adjusting for differences in year of diagnosis, age, gender, ethnicity, and the presence of intestinal metaplasia of the gastric cardia. Results : There were 340 patients with Barrett's oesophagus first diagnosed between 1981 and 2000. The average length of Barrett's oesophagus at the time of first diagnosis was 4.4 cm (range: 0.5–16). Of all patients, 139 (41%) had prior use of histamine‐2 receptor antagonists, or proton‐pump inhibitors (41 used both), and 201 (59%) used neither prior to the diagnosis of Barrett's oesophagus. The mean length of Barrett's oesophagus was significantly shorter in patients with prior use of proton‐pump inhibitors (3.4 cm) or proton‐pump inhibitors and histamine‐2 receptor antagonists (3.1 cm) when compared to those with none of these medications (4.8 cm). In the multivariate linear regression model, the prior use of proton‐pump inhibitors or either proton‐pump inhibitors or histamine‐2 receptor antagonists was an independent predictor of shorter length of Barrett's oesophagus (P = 0.0396). Conclusions : The use of acid suppressive therapy among patients is associated with a reduction in the eventual length of newly diagnosed Barrett's oesophagus with gastro‐oesophageal reflux disease. This finding is independent of the year of diagnosis or demographic features of patients. Further studies are required to confirm this finding.

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Section: Introductionmentioning

confidence: 97%

“…[5][6][7][8][9][10][11][12][13][14][15][16]. Of all patients, 139 (41%) had prior use of histamine-2 receptor antagonists, or proton-pump inhibitors (41 used both), and 201 (59%) used neither prior to the diagnosis of Barrett's oesophagus.…”

mentioning

confidence: 99%

The length of newly diagnosed Barrett's oesophagus and prior use of acid suppressive therapy

El–Serag

Aguirre

Kuebeler

et al. 2004

Aliment Pharmacol Ther

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“…The reason for intestinal metaplasia appears to be chronic reflux of gastric (generally acidic) contents into the lower esophagus (Fass et al, 2001). The process leading to intestinal metaplasia may be associated with chronic inflammation (Atherfold and Jankowski, 2006).…”

Section: The Upper Gastrointestinal Tractmentioning

confidence: 99%

Role of Toll-like receptors in gastrointestinal malignancies

2008

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“…The development of a Barrett's esophagus is the result of a longstanding reflux of acid and bile. 11,12 The etiopathogenesis of cardiac adenocarcinomas is less clear. Carditis and intestinal metaplasia are proposed as precursor lesions for this cancer.…”

mentioning

confidence: 99%

Identical cytokeratin expression pattern CK7+/CK20− in esophageal and cardiac cancer: etiopathological and clinical implications

et al. 2004

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Surgical treatment and prognosis is different in esophageal, cardiac and distal gastric adenocarcinomas. Determination of the origin, in particular of adenocarcinomas situated at the gastroesophageal junction, may be difficult. It has been suggested that esophageal adenocarcinomas are characterized by a specific cytokeratin pattern, namely the CK7 þ /CK20À pattern. According to the same authors, this cytokeratin pattern is absent in gastric adenocarcinomas. The aim of our study is to evaluate if this cytokeratin pattern CK7 þ /CK20À is absent in cardiac and distal gastric adenocarcinomas. Therefore, we evaluated the combined immunohistochemical expression of CK7 and CK20 on paraffin-embedded material of 214 resection specimens for adenocarcinoma, comprising 66 esophageal, 73 cardiac and 75 distal gastric adenocarcinomas (UICC-classification). The adenocarcinomas were subtyped into intestinal-and diffuse-type according to the Lauren classification. The immunohistochemical staining was considered as positive if 50% or more of the tumor cells were stained. Statistical analysis has been performed applying the v 2 -test. The tumors situated at the gastroesophageal junction, esophageal as well as cardiac adenocarcinomas, showed predominantly a CK7 þ /CK20À expression pattern (67 vs 68%), whereas this cytokeratin pattern is rather uncommon in distal gastric adenocarcinomas (31%, Po4 Â 10 À5 ). Independent of their localization, intestinal-as well as diffuse-type adenocarcinomas have a similar cytokeratin pattern. Our data show that the combined expression of CK7 and CK20 is different for the adenocarcinomas situated on both sides of the gastroesophageal junction compared to the distal gastric adenocarcinomas. However, in contrast to data in the literature, the combined expression of CK7 and CK20 has a low specificity in the distinction between esophageal and cardiac adenocarcinomas. This may suggest a similar origin (cell lineage) and thus may have an impact on therapeutic strategies.

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Correlation of oesophageal acid exposure with Barrett's oesophagus length

Cited by 134 publications

References 23 publications

The length of newly diagnosed Barrett's oesophagus and prior use of acid suppressive therapy

The length of newly diagnosed Barrett's oesophagus and prior use of acid suppressive therapy

Role of Toll-like receptors in gastrointestinal malignancies

Identical cytokeratin expression pattern CK7+/CK20− in esophageal and cardiac cancer: etiopathological and clinical implications

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