BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not scr...BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not screened.Current practice guidelines include male gender as a predisposing factor for BE and EAC.The population-based clinical evidence regarding female gender remains limited.AIM To study comparative trends of gender disparities in patients with BE in the United States.METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)database.Patients with a primary or secondary diagnosis code of BE were identified.The major outcome of interest was determining the gender disparities in patients with BE.Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.RESULTS We identified 1204190 patients with BE for the study period.Among the included patients,717439(59.6%)were men and 486751(40.4%)were women.The mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(H.pylori),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H.pylori and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019.The existing knowledge concerning BE development has historically focused on men,but our findings show that the risk in women is not insignificant.展开更多
In this editorial,we explored currently available strategies for reducing the occurrence of esophageal strictures following circumferential endoscopic submucosal dissection.This manuscript provided a comprehensive ove...In this editorial,we explored currently available strategies for reducing the occurrence of esophageal strictures following circumferential endoscopic submucosal dissection.This manuscript provided a comprehensive overview of the various strategies including recent insights from Wang et al.To this end,stenosis-related symptoms such as dysphagia and vomiting can severely affect a patient’s quality of life.Therefore,we assess the efficacy of both reactive and proactive measures,ranging from traditional approaches like endoscopic balloon dilation and steroid administration to more advanced techniques,including tissue engineering and polyglycolic acid sheet placement.However,no single treatment has shown high efficacy,particularly for resections involving the entire circumference.Despite these shortcomings,the combination of different strategies may improve patient outcomes,although further large-scale studies are needed for validation.展开更多
目的:探讨三结构域蛋白家族24(tripartite motif-containing protein 24,TRIM24)、c-myc及ARF蛋白在食管鳞状细胞癌组织中的表达及其意义。方法:选取2018年01月至2022年12月期间承德市中心医院接受手术治疗的102例食管鳞癌患者临床病理...目的:探讨三结构域蛋白家族24(tripartite motif-containing protein 24,TRIM24)、c-myc及ARF蛋白在食管鳞状细胞癌组织中的表达及其意义。方法:选取2018年01月至2022年12月期间承德市中心医院接受手术治疗的102例食管鳞癌患者临床病理资料作为研究对象(实验组),同时选取癌旁正常食管黏膜组织54例(对照组),采用免疫组化(Envision法)对TRIM24、c-myc及ARF蛋白进行检测,观察三者在鳞癌组织及癌旁正常食管黏膜组织中的表达情况,并分析三者的表达与临床病理特征的关系,同时研究三者于食管鳞癌组织内表达的相关性。结果:TRIM24、c-myc及ARF在鳞癌组织及癌旁正常食管黏膜组织中阳性表达率分别为72.62%vs 7.45%、74.36%vs 13.85%、26.56%vs 83.18%,三种蛋白在鳞癌组织及正常食管黏膜组织中的表达差异具有统计学意义(P均<0.05);经分析,食管鳞癌组织中的TRIM24、c-myc及ARF蛋白表达与癌的分化程度、淋巴结转移、临床分期具有显著相关性(P均<0.05);经Spearman相关性分析,食管鳞癌组织中TRIM24与c-myc蛋白表达呈正相关(r=0.587,P<0.05),TRIM24与ARF蛋白表达呈负相关(r=-0.601,P<0.05),c-myc与ARF蛋白表达呈负相关(r=-0.465,P<0.05)。结论:TRIM24、c-myc、ARF的异常表达可能对食管鳞状细胞癌的发生及发展有一定关系。因此,c-myc、TRIM24和ARF可能作为新的潜在治疗靶点,为食管鳞癌患者的个体化治疗提供新的方向。展开更多
文摘BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not screened.Current practice guidelines include male gender as a predisposing factor for BE and EAC.The population-based clinical evidence regarding female gender remains limited.AIM To study comparative trends of gender disparities in patients with BE in the United States.METHODS A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)database.Patients with a primary or secondary diagnosis code of BE were identified.The major outcome of interest was determining the gender disparities in patients with BE.Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.RESULTS We identified 1204190 patients with BE for the study period.Among the included patients,717439(59.6%)were men and 486751(40.4%)were women.The mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(H.pylori),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H.pylori and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among women has steadily increased from 2009 to 2019.The existing knowledge concerning BE development has historically focused on men,but our findings show that the risk in women is not insignificant.
文摘In this editorial,we explored currently available strategies for reducing the occurrence of esophageal strictures following circumferential endoscopic submucosal dissection.This manuscript provided a comprehensive overview of the various strategies including recent insights from Wang et al.To this end,stenosis-related symptoms such as dysphagia and vomiting can severely affect a patient’s quality of life.Therefore,we assess the efficacy of both reactive and proactive measures,ranging from traditional approaches like endoscopic balloon dilation and steroid administration to more advanced techniques,including tissue engineering and polyglycolic acid sheet placement.However,no single treatment has shown high efficacy,particularly for resections involving the entire circumference.Despite these shortcomings,the combination of different strategies may improve patient outcomes,although further large-scale studies are needed for validation.
