摘要
目的探讨胆汁酸在Barrett食管(BE)及食管腺癌(EAC)发病中的作用,为预防、治疗BE、EAC的发生提供参考依据。方法选取2017年8月10日至2020年10月30日于茌平区人民医院就诊,反流性疾病问卷评分>12分的患者,对其行无痛胃镜检查,镜下胃液留取及食管下段(胃食管结合部上1 cm处)黏膜组织活检,进行胃液、食管下段黏膜胆汁酸浓度检测。结果所检患者胃液中均检测到不同浓度的胆汁酸,且BE、EAC患者胃液及食管下段黏膜组织总胆汁酸浓度较非糜烂性反流病(NERD)、反流性食管炎(RE)患者胃液及食管下段黏膜组织总胆汁酸浓度明显升高(P值均<0.05)。结论胆汁酸在BE、EAC患者胃液及食管下段黏膜组织中的浓度较无Barrett食管的胃食管反流病患者的浓度明显升高,提示胆汁反流可能与胃食管结合部黏膜细胞恶性转化相关,抑制胆汁反流可能成为预防BE、EAC发生的必要干预措施。
Objective To explore the roles of bile acid in the pathogenesis of Barrett esophagus(BE)and esophageal adenocarcinoma(EAC), and to provide reference for the prevention and treatment of BE and EAC.MethodsPatients with regurgitation disease questionnaire score>12 points were selected from August 10, 2017 to October 30, 2020 at Chiping People′s Hospital.The patients underwent painless gastroscopy, gastric juice was collected under gastroscope, and mucosa biopsy was performed in the lower esophagus(1 cm above the gastroesophageal junction). The concentration of bile acid in gastric juice and mucosa of lower esophagus was detected.ResultsBile acid of different concentrations was detected in gastric juice of all patients, and the total bile acid concentration in gastric juice and lower esophageal mucosal tissues of BE and EAC patients was significantly higher than that in gastric juice and lower esophageal mucosal tissues of non-erosive reflux disease(NERD)and reflux esophagitis(RE)patients(bothP<0.05).ConclusionThe concentration of bile acid in gastric juice and lower esophageal mucosa of patients with BE and EAC is significantly higher than that of patients with gastroesophageal reflux diseases without Barrett esophagus, suggesting that bile reflux may be related to the malignant transformation of mucosal cells at the gastroesophageal junction, and inhibition of bile reflux may be a necessary intervention to prevent the occurrence of BE and EAC.
作者
杨克利
丁岩军
季万胜
Keli Yang;Yanjun Ding;Wansheng Ji(Department of Gastroenterology,Liaocheng Chiping District People′s Hospital,Chiping 252100,China;Department of Gastroenterology,Affiliated Hospital of Weifang Medical University,Weifang 261031,China)
出处
《中华消化病与影像杂志（电子版）》
2022年第3期154-157,共4页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
