title: Does short-segment columnar-lined esophagus elongate during a mean follow-up period of 5.7 years?
abstract: BACKGROUND
  The length of Barrett's esophagus is considered to be important because it is associated with the risk of neoplasia. In Japan, there is a high prevalence of short-segment columnar-lined esophagus (SS-CLE). The natural history of SS-CLE is not fully understood, so the aim of the present study was to investigate the chronological changes of SS-CLE.
  
  
  METHODS
  The subjects were 500 consecutive patients with SS-CLE (327 men and 173 women; mean age: 64.0 years) diagnosed between January 2001 and July 2002 at our hospital based on the definition of SS-CLE proposed by the Japanese Society for Esophageal Diseases. Follow-up endoscopy was carried out annually for a mean period of 5.7 ± 1.2 years. The cumulative probability of SS-CLE showing elongation was estimated by the Kaplan-Meier method, and factors related to endoscopic findings making an independent contribution to elongation were determined with Cox's proportional hazard model.
  
  
  RESULTS
  Elongation of SS-CLE occurred in 29 patients (5.8%) during the follow-up period and the cumulative 5-year probability of elongation was 16.6%. There was no progression of SS-CLE to Barrett's adenocarcinoma. The absence of atrophic gastritis (adjusted odds ratio (aOR): 23.4; 95%CI [6.5, 83.8]), the presence of reflux esophagitis (aOR: 4.53; 95%CI [1.2, 16.4]), and the flame-shaped type of SS-CLE (aOR: 22.4; 95%CI [7.8, 64.0]) were found to be independent contributors to the elongation of SS-CLE.
  
  
  CONCLUSIONS
  The present study demonstrated that SS-CLE remains stable in length over time, especially in patients without atrophic gastritis, as well as in those with reflux esophagitis and/or flame-shaped SS-CLE at initial examination.
authors.affiliation: Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan. n_manabe@hkg.odn.ne.jp
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imamura
authors.forename: Tomoari
authors.initials: T
authors.lastname: Kamada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kusunoki
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Inoue
authors.forename: Akiko
authors.initials: A
authors.lastname: Shiotani
authors.forename: Jiro
authors.initials: J
authors.lastname: Hata
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001471:Barrett Esophagus / Q000473:pathology*; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology*; D004942:Esophagitis, Peptic / Q000473:pathology; D004943:Esophagogastric Junction / Q000473:pathology; D004945:Esophagoscopy; D005260:Female; D005757:Gastritis, Atrophic / Q000473:pathology; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000473:pathology*; D016016:Proportional Hazards Models; D012307:Risk Factors