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Z-line alterations and gastroesophageal reflux: an endoscopic population-based prospective cohort study
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.ORCID-id: 0000-0002-9234-7946
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
Vise andre og tillknytning
2019 (engelsk)Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 54, nr 9, s. 1065-1069Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background and study aims: Barrett's esophagus is a premalignant condition in the distal esophagus associated with esophageal adenocarcinoma. Since gastroesophageal reflux is known to be of etiological importance in both Barrett's esophagus and esophageal adenocarcinoma, we aimed to study which endoscopic alterations at the Z-line can be attributed to a previous history of reflux symptoms. Patients and methods: From 1988, a population cohort in Sweden has been prospectively studied regarding gastrointestinal symptoms, using a validated questionnaire. In 2012, the population was invited to undergo a gastroscopy and participate in the present study. In order to determine which endoscopic alterations that can be attributed to a previous history of gastroesophageal reflux, three different endoscopic definitions of columnar-lined esophagus (CLE) were used: (1) ZAP I, An irregular Z-line with a suspicion of tongue-like protrusions; (2) ZAP II/III, Distinct, obvious tongues of metaplastic columnar epithelium; (3) CLE >= 1 cm, The Prague C/M-classification with a minimum length of 1 cm. Results: A total of 165 community subjects were included in the study. Of these, 40 had CLE >= 1 cm, 99 had ZAP I, and 26 had ZAP II/III. ZAP II/III was associated with an over threefold risk of previous GER symptoms (OR: 3.60, CI: 1.49-8.70). No association was found between gastroesophageal reflux and ZAP I (OR: 2.06, CI: 0.85-5.00), or CLE >= 1 cm (OR: 1.64, CI: 0.77-3.49). Conclusions: In a general community, the only endoscopic alteration to the Z-line definitely linked to longstanding GER symptoms was the presence of obvious tongues of metaplastic columnar epithelium (ZAP II/III).

sted, utgiver, år, opplag, sider
TAYLOR & FRANCIS LTD , 2019. Vol. 54, nr 9, s. 1065-1069
Emneord [en]
Barrett's esophagus, endoscopy, gastroesophageal reflux
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-164536DOI: 10.1080/00365521.2019.1656775ISI: 000484019100001PubMedID: 31453726OAI: oai:DiVA.org:umu-164536DiVA, id: diva2:1370269
Tilgjengelig fra: 2019-11-14 Laget: 2019-11-14 Sist oppdatert: 2019-11-14bibliografisk kontrollert

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