Prevalence and pathogenesis of Barrett's esophagus in Luoyang, China.
BACKGROUND
Prevalence of Barrett's esophagus (BE) in Luoyang, China, has not been reported, and its pathogenesis is controversial. The aim of this study was therefore to investigate the prevalence of BE and its underlying factors in the city of Luoyang.


METHODS
This was a prospective study in one center. Many patients were analyzed using endoscopy who showed upper gastrointestinal symptoms between August 2006 and June 2007. In addition, the effect of apoptosis-related proteins and heat shock proteins upon BE's pathogenesis were also investigated by an immunohistochemical protocol.


RESULTS
Prevalence of BE was at 4.55% and the mean age of those affected was about 10 years older than for esophagitis. Typical reflux symptoms were significantly lower than with esophagitis, whereas signs of caspase-3 and HSP105 elevation were significantly higher. Expression of TERT, HSP70 and HSP90α in BE cases was significantly lower than in esophagitis. However, there was no statistical difference between the two groups in expression of HSP27.


CONCLUSIONS
The prevalence of BE is high in Luoyang, which could result from esophagitis despite typical reflux symptoms being relatively uncommon. Initiation and development of BE might be the result of accelerated proliferation, apoptosis and differentiation of original cells to intestinal epithelium.
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing, China. rugangzhangcn@163.com
Ru-Gang
RG
Zhang
Chang-Song
CS
Wang
Cun-Fang
CF
Gao
D000230:Adenocarcinoma / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D001471:Barrett Esophagus / Q000453:epidemiology* / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D053148:Caspase 3 / Q000378:metabolism; D002681:China; D004941:Esophagitis / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D050957:HSP110 Heat-Shock Proteins / Q000378:metabolism; D018840:HSP70 Heat-Shock Proteins / Q000378:metabolism; D018841:HSP90 Heat-Shock Proteins / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D019098:Telomerase / Q000378:metabolism
D014408:Biomarkers, Tumor; D050957:HSP110 Heat-Shock Proteins; D018840:HSP70 Heat-Shock Proteins; D018841:HSP90 Heat-Shock Proteins; C533585:HSP90AA2P protein, human; C097205:HSPH1 protein, human; C509186:TERT protein, human; D019098:Telomerase; D053148:Caspase 3