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Abstract：
OBJECTIVE: Although gastroesophageal reflux disease (GERD) symptoms are an essential criterion for Barrett\'s esophagus (BE) screening in most gastroenterology society guidelines, a significant proportion of BE and esophageal adenocarcinoma (EAC) cases do not endorse them. In a systematic review and meta-analysis, we aimed to study the prevalence of BE/EAC in those with and without GERD.
METHODS: A systematic search was conducted through 5 major databases for studies reporting prevalence of BE/EAC in patients with and without GERD. Pooled proportions and odds ratios (ORs) of BE, long-segment BE, short-segment BE, dysplasia, and EAC in patients with and without GERD were synthesized.
RESULTS: Forty-three articles (12,883 patients with GERD; 51,350 patients without GERD) were included in the final analysis. BE prevalence was 7% (95% confidence interval [CI], 5.8%-8.5%) and 2.2% (95% CI, 1.6%-3%) among individuals with and without GERD, respectively. EAC prevalence was 0.6% (95% CI, 0.4%-1%) and 0.1% (95% CI, 0%-0.2%) in those with and without GERD, respectively. The overall risks for BE (OR, 2.91; 95% CI, 2.06-4.11) and long-segment BE (OR,4.17; 95% CI, 1.78-9.77) were higher in patients with GERD, but the risk for short-segment BE (OR, 1.77; 95% CI, 0.89-3.52) did not differ between the two groups. In 9 population-based high-quality studies (2244 patients with GERD; 3724 patients without GERD), BE prevalence in patients without GERD was 4.9% (95% CI, 2.6%-9%). BE prevalence was highest in North American studies (10.6% [GERD] and 4.8% [non-GERD]).
CONCLUSIONS: BE prevalence in those without GERD is substantial, particularly in large high-quality population-based studies. These data are important to factor in future BE/EAC early detection guidelines.
METHODS: A systematic search was conducted through 5 major databases for studies reporting prevalence of BE/EAC in patients with and without GERD. Pooled proportions and odds ratios (ORs) of BE, long-segment BE, short-segment BE, dysplasia, and EAC in patients with and without GERD were synthesized.
RESULTS: Forty-three articles (12,883 patients with GERD; 51,350 patients without GERD) were included in the final analysis. BE prevalence was 7% (95% confidence interval [CI], 5.8%-8.5%) and 2.2% (95% CI, 1.6%-3%) among individuals with and without GERD, respectively. EAC prevalence was 0.6% (95% CI, 0.4%-1%) and 0.1% (95% CI, 0%-0.2%) in those with and without GERD, respectively. The overall risks for BE (OR, 2.91; 95% CI, 2.06-4.11) and long-segment BE (OR,4.17; 95% CI, 1.78-9.77) were higher in patients with GERD, but the risk for short-segment BE (OR, 1.77; 95% CI, 0.89-3.52) did not differ between the two groups. In 9 population-based high-quality studies (2244 patients with GERD; 3724 patients without GERD), BE prevalence in patients without GERD was 4.9% (95% CI, 2.6%-9%). BE prevalence was highest in North American studies (10.6% [GERD] and 4.8% [non-GERD]).
CONCLUSIONS: BE prevalence in those without GERD is substantial, particularly in large high-quality population-based studies. These data are important to factor in future BE/EAC early detection guidelines.
摘要：
目的：虽然胃食管反流病（GERD）症状是大多数胃肠病学指南中Barrett食管（BE）筛查的基本标准，相当比例的BE和食管腺癌（EAC）病例不认可它们。在系统评价和荟萃分析(SRM)中，我们旨在研究有和没有GERD的患者中BE/EAC的患病率.
方法：通过5个主要数据库进行系统检索，以研究报告有和无GERD患者的BE/EAC患病率。BE的合并比例和赔率比(OR)，长段BE(LSBE)，短段BE(SSBE)，有和没有GERD的患者的异型增生和EAC被合成。
结果：最终分析包括43篇文章（12,883例患者；51,350例无GERD）。在有和无GERD的个体中，BE患病率分别为7%（95%CI5.8-8.5）和2.2%（1.6-3），分别。有和没有GERD的EAC患病率分别为0.6%（0.4-1）和0.1%（0-0.2），分别。GERD患者的BE（OR=2.91;2.06-4.11）和LSBE（OR=4.17;1.78-9.77）的总体风险较高，但两组的SSBE风险(OR=1.77;0.89-3.52)没有差异.在9项基于人群的高质量研究中（2244例患者；3724例无GERD），无GERD患者的BE患病率为4.9%（95%CI2.6-9）。BE患病率在北美研究中最高(10.6%[GERD]和4.8%[非GERD])。
结论：无GERD患者的BE患病率相当高，特别是在大型高质量的基于人群的研究中。这些数据对于考虑未来的BE/EAC早期检测指南非常重要。
方法：通过5个主要数据库进行系统检索，以研究报告有和无GERD患者的BE/EAC患病率。BE的合并比例和赔率比(OR)，长段BE(LSBE)，短段BE(SSBE)，有和没有GERD的患者的异型增生和EAC被合成。
结果：最终分析包括43篇文章（12,883例患者；51,350例无GERD）。在有和无GERD的个体中，BE患病率分别为7%（95%CI5.8-8.5）和2.2%（1.6-3），分别。有和没有GERD的EAC患病率分别为0.6%（0.4-1）和0.1%（0-0.2），分别。GERD患者的BE（OR=2.91;2.06-4.11）和LSBE（OR=4.17;1.78-9.77）的总体风险较高，但两组的SSBE风险(OR=1.77;0.89-3.52)没有差异.在9项基于人群的高质量研究中（2244例患者；3724例无GERD），无GERD患者的BE患病率为4.9%（95%CI2.6-9）。BE患病率在北美研究中最高(10.6%[GERD]和4.8%[非GERD])。
结论：无GERD患者的BE患病率相当高，特别是在大型高质量的基于人群的研究中。这些数据对于考虑未来的BE/EAC早期检测指南非常重要。
