目的 探讨影响Barrett's食管（Barrett's esoplaagus, BE）粘膜中肠上皮化生（intestlnal rileta-plasia, IM）发生的因素。方法 应用胃镜下和组织学染色方法诊断IM，并比较36例存在IM的BE患者与11例不伴有IM的BE患者在年龄、胃镜下表现及食管运动功能方面的特点。结果 BE患者的年龄、胃镜下BE：粘膜的长度及形态，均与IM的发生率有关（P<0.05）；但食管炎的程度及食管运动功能与IM的发生率无关（P>0.05）。结论 年龄在30岁以上、胃镜下舌型BE及长度3.5cm心上与IM的发生率增加，可作为判断BE预后厦筛选随访的临床参考指标；食管运动功能障碍在BE发生肠上皮化生的过程中可能不起主要作用。

目的 研究Barrett食管（Barrett's Esophagus, BE）在国人内镜下的发病状况和发病特点。并初步探讨其可能的发病机制。方法 应用胃镜检查及灌注式食管测压方法研究了6l例BE与126例反流性食管炎（RE）患者在临床表现及食管运动功能方面的区别。结果 BE组与RE组在各项反流症状上无区别（P>0.05）；但BE组台并食管炎的情况少，程度也轻（P<0.001）；两组合并消化性溃疡的发生宰相似（P>0.05）；BE组较无并发症的RE组胃内压力高（P<0.05）；其它各项食管测压结果两组无区别（P>0.05）；结论 BE在中国人中的发病率和发病特点与西方人有不同之处有待于今后更深人系统的研究；食管运动功能缺陷可能不是导致中国人群中RE发展为BE的主要原因。

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。