Iwaya Y, Shimamura Y, Goda K, Rodríguez de Santiago E, Coneys JG, Mosko JD, Kandel G, Kortan P, May G, Marcon N, Teshima C. Clinical characteristics of young patients with early Barrett’s neoplasia. World J Gastroenterol 2019; 25(24): 3069-3078 [PMID: 31293342 DOI: 10.3748/wjg.v25.i24.3069]
Corresponding Author of This Article
Yugo Iwaya, MD, PhD, Doctor, Advanced Therapeutic Endoscopy Centre, St Michael’s Hospital, University of Toronto, 30 Bond Street, Toronto M5B 1W8, Ontario, Canada. yiwaya@shinshu-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 28, 2019; 25(24): 3069-3078 Published online Jun 28, 2019. doi: 10.3748/wjg.v25.i24.3069
Table 1 Patient characteristics
Young (≤ 50 yr)
Old (> 50 yr)
P value
(n = 45)
(n = 405)
Sex (male)
39/45 (87%)
342/405 (84%)
0.86
Ethnicity (white)
43/44 (98%)
377/387 (97%)
0.70
BMI, kg/m2 (mean ± SD)
29.69 ± 6.05
28.53 ± 5.72
0.09
BMI > 30 kg/m2
21/44 (48%)
124/389 (32%)
0.04
Diabetes
5/45 (11%)
91/390 (23%)
0.01
Hypertension
13/45 (29%)
211/382 (55%)
< 0.001
Family history of malignancy
21/44 (48%)
234/382 (61%)
0.08
Family history of esophageal adenocarcinoma
1/44 (2%)
17/382 (5%)
0.78
GERD symptoms
24/44 (55%)
148/386 (38%)
0.04
Smoking
Ever smoking
25/44 (57%)
297/393 (76%)
0.01
Current smoking
4/44 (9%)
47/392 (11%)
0.75
Pack-years (mean ± SD)
13.97 ± 15.56
23.46 ± 27.21
0.02
Alcohol
Ever alcohol
37/45 (82%)
297/387 (77%)
0.52
Current alcohol
31/45 (69%)
241/375 (64%)
0.54
Medication use
Proton pump inhibitors
38/43 (88%)
335/374 (90%)
0.98
Low-dose aspirin
5/45 (11%)
130/388 (34%)
< 0.01
NSAIDs
4/45 (9%)
34/384 (9%)
0.79
Statins
10/45 (22%)
189/388 (49%)
< 0.001
Endoscopy
Prague C, median (IQR), cm
2 (0-5)
1 (0-5)
0.52
Prague M, median (IQR), cm
4 (2-7)
4 (2-7)
0.43
Hiatus hernia
35/45 (78%)
350/405 (86%)
0.12
Table 2 Adenocarcinoma/high-grade dysplasia risk according to multivariate analysis: Young vs old
Adjusted Odds ratio
95% confidence interval
P value
BMI > 30
2.06
1.07-3.98
0.03
Ever smoking
0.39
0.20-0.75
< 0.01
Ongoing GERD symptoms
2.00
1.04-3.85
0.04
Family history of esophageal adenocarcinoma
0.73
0.09-5.85
0.77
Ethnicity (white)
0.77
0.09-6.42
0.81
Sex (Male)
1.44
0.56-3.70
0.45
Table 3 Pathological features of esophageal adenocarcinoma, n (%)
Young (≤ 50 yr)
Old (> 50 yr)
P value
(n = 45)
(n = 405)
Histology
EAC
31 (69)
317 (78)
0.15
HGD
14 (31)
88 (22)
EAC depth
M1
7 (23)
63 (20)
M2
8 (26)
75 (24)
M3
8 (26)
47 (15)
M4
4 (13)
96 (30)
SM
4 (13)
36 (11)
0.41
Differentiation
G1
21 (68)
212 (67)
G2
6 (19)
91 (29)
G3
4 (13)
14 (4)
0.22
Lympho-vascular invasion
1 (3)
32 (10)
0.36
Vertical margin positive rate
3 (10)
32 (10)
0.81
Table 4 Clinical outcomes following endoscopic treatment
Young (≤ 50 yr)
Old (> 50 yr)
P value
(n = 30)
(n = 257)
Complete eradication of neoplasia
28/30 (93%)
220/257 (86%)
0.38
Recurrence of neoplasia
4/28 (14%)
40/220 (18%)
0.81
Complete eradication of intestinal metaplasia
23/30 (77%)
159/257 (62%)
0.16
Recurrence of intestinal metaplasia
7/23 (30%)
41/159 (26%)
0.83
Citation: Iwaya Y, Shimamura Y, Goda K, Rodríguez de Santiago E, Coneys JG, Mosko JD, Kandel G, Kortan P, May G, Marcon N, Teshima C. Clinical characteristics of young patients with early Barrett’s neoplasia. World J Gastroenterol 2019; 25(24): 3069-3078