Mastykova E.K., Konorev M.R., Matveyenko M.E.
The peculiarities of the gastroesophageal reflux disease course in the presence of gastric metaplasia of the esophageal mucous membrane
Abstract.
Objectives. To assess the prognostic value of diagnosing gastric metaplasia of the esophageal mucous membrane in the development of erosive form of the gastroesophageal reflux disease (GERD).
Material and methods. Prospective, comparative study of 102 patients with GERD (the mean age 55 (40; 63) years, 63 men (61,7%) and 39 women (38,3%)) was conducted. The term of monitoring averaged 1,7 (1,4; 2,5) years. All included patients underwent endoscopy for the diagnosis of erosive esophagitis and biopsies were obtained from the esophagus in order to determine the metaplastic changes. Frequency analysis of the development of erosions was conducted filling in the table 2x2 (s2 criterion was used for the processing). To estimate the risk factors for the erosive esophagitis development (male gender, hiatus hernia and gastric metaplasia) the logistic regression was used.
Results. Prognostic risk factors reliably influencing the erosive esophagitis development (male gender, hiatus hernia and gastric metaplasia of the esophageal mucous membrane) were studied. High rates of the prognostic factor (the presence of gastric metaplasia) were determined for the prognosis of erosive esophagitis development in patients with GERD: sensitivity – 80,7% (95% CI: 73,6-94,4%); specificity – 84,0% (95% CI: 69,8-91,7%); predictive accuracy – 82,4% (95% CI: 74,8-89,9%); positive relative risk – 4,3, negative relative risk - 0,2 (95% CI: 0,1-0,39%); odds ratio – 22,05 (95% CI: 7,7-62,6%).
Conclusions. Gastric metaplasia of the esophageal mucous membrane is a reliable risk factor for the development of erosive esophagitis disregarding other factors (male gender and hiatus hernia).
Key words: esophagus, GERD, gastric metaplasia, erosive esophagitis.
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