DOES SHORT-SEGMENT COLUMNAR-LINED ESOPHAGUS ELONGATE DURING A MEAN FOLLOW-UP PERIOD OF 5.7 YEARS?

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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.

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