AIM: To study the prevalence of Barrett's esophagus in Chinese and its correlation with gastroesophageal reflux. METHODS: This study was carried out in a large prospective series of 391 patients who had undergone upper endoscopy. The patients were divided into 3 groups according to the position of squamocolumnar junction (SCJ). Reflux esophagitis (RE) and its degree were recorded. Intestinal metaplasia (IM) in biopsy specimen was typed according to histochemistry and HE and alcian blue (pH2.5) staining separately. Results correlating with clinical, endoscopic, and pathological data were analysed. RESULTS: The prevalence of IM endoscopically appearing Long-segment Barrett’s Esophagus (LSBE) was 26.53%, Short-segment Barrett’s Esophagus (SSBE) was 33.85%and gastroesophageal junction (GEJ) was 34.00%. IM increased with age of above 40 years old and no difference was found between male and female. Twelve were diagnosed as dysplasia (7 low-grade, 5 high-grade), 16 were diagnosed as cardiac adenocarcinoma and 1 as esophageal adenocarcinoma. The more far away the SCJ moved upward above GEJ, the higher the prevalence and the more severe the RE were. CONCLUSION: There was no difference of the prevalence of IM in different places of SCJ, and IM increased with age of above 40 years old. It is important to pay attention to dysplasia in the distal esophagus and gastro-esophageal junction, and adenocarcinoma is more common in cardia than in esophagus. BE is a consequence of gastroesophageal reflux disease.

目的 探讨西安地区内镜检出并经病理证实的上消化道癌症的临床流行病学特点。方法 选择1991年1月至2002年12月于西安市三所大型医院进行胃镜检查并经病理确诊的上消化道癌症患者，对其临床、病理、内镜及流行病学特征进行分析。结果 12年来上消化道癌症总检出率为8.135，其中食管癌检出率3.42%，贲门癌检出率1.44%，非贲门部胃癌检出率3.26%，十二指肠癌检出率0.01%。12年来食管癌和胃癌的检出率虽有一些波动，但呈明显下降趋势（P=0.000），贲门癌呈现出较为平缓的上升趋势（P=0.000）。贲门癌的男女性别比为6.29：1，远较胃癌和食管癌为高（2.92：1和3.09：1,P=0.000）。食管鳞癌和腺癌构成无明显变化（P=0.562），食管腺癌没有明显的升高趋势（P=0.557）。结论 西安地区食管癌居上消化道癌症之首；12年来胃癌、食管癌的检出率明显下降，贲门癌的检出率呈明显升高趋势；贲门癌为不同于食管癌和胃癌的独立疾病。

目的 研究环氧台酶2（Cox 2）蛋白及其mRNA在食管癌、胃癌、贲门癌中的表达量和细胞内定位的异同，探讨Cox 2抑制剂对贲门癌的预防作用。方法 免疫组化法定量检测了3种肿瘤共48例标本的Cox 2蛋白，RTPCR法和原位PCR法检测了其中29例标本的Cox 2mRNA及其在组织细胞内的定位。结果 食管癌、胃癌、贲门癌的Cox 2染色分数分别为4.15±1.39，3.66±1.16，2.93±1.03，均高于正常组织。贲门癌的染色分数与胃癌的无显著性差异。Cox 2mRNA在贲门癌的检出率为87.5%（ISPCR），75%（RTPCR），在胃癌、食管癌的检出率为100%，无显著性差异。Cox 2mRNA位于癌细胞胞浆，胞核中也有少量存在，其在3种肿瘤中相同。结论 Cox 2在贲门癌中显著升高，其表达特点与胃癌、食管癌中基本相同。Cox 2抑制剂对贲门癌可能有预防作用。