RISK FACTORS OF DYSPLASIA AND ADENOCARCINOMA IN BARRETT'S ESOPHAGUS

Aims:

Barrett's esophagus (BE) is a rare lesion that can progress to adenocarcinoma of the lower esophagus Endoscopic and histological monitoring is necessary to detect these lesions early and to propose appropriate management.

The purpose of this work was to determine the risk factors of dysplasia or degeneration during BE.

Methods:

A retrospective descriptive study (2009 – 2016) including all patients presenting a Barrett's esophagus in the endoscopy was conducted. The BE was classified according to Prague and the diagnosis was retained on the histological data of the esophageal biopsies. The patients were divided into two groups: group 1 (G 1) BE without dysplasia, group 2 (G2) BE with dysplasia (low or high grade) or adenocarcinoma. A statistical study (SPSS 23.0 software, p significant if < 0.05) was performed to compare the two groups.

Results:

Eighty-three patients with histologically confirmed BE were included. They were distributed as follows: group 1: 70 patients and group 2: 13 patients. Of these, eight patients (9.6%) had dysplasia, only one of high grade, and five patients (6%) had adenocarcinoma. Comparing the two groups, the risk factors identified of dysplasia or degeneration were age with mean age (56 years old vs. 61 years old) respectively in groups 1 and 2 (p = 0.04) and dysphagia as functional sign (8%, vs. 46%, p = 0.003, OR = 9.1). There was no significant difference in sex ratio [H/F] (1.25 vs. 1.6, p = 0.08) neither in the other signs (anemia, gastroesophageal reflux). The two groups were comparable in the mean length of the BE (17 mm vs. 26 mm, p = 0.33) and the HP infestation rate (46% vs. 46%, p = 0.98).

Conclusions:

Only advanced age and dysphagia were predictive of dysplasia or degeneration during BE. An intensification of the monitoring protocol of these patients could be proposed to allow detection and early management of dysplasia.