Supplementary Material for: Relationship between Helicobacter pylori eradication and Barrett’s esophagus elongation

Introduction:
Helicobacter pylori eradication therapy may worsen gastroesophageal reflux disease that is a significant risk factor for Barrett’s esophagus. However, the relationship between eradication therapy and Barrett’s esophagus remains controversial. This study evaluated the impact of Helicobacter pylori eradication on the lengthening of Barrett's esophagus.
Materials and Methods:
We conducted a retrospective analysis of consecutive patients who successfully underwent Helicobacter pylori eradication between 2004 and 2017. Endoscopic images obtained before and after eradication therapy were compared for Barrett's esophagus length according to the Prague C&M criteria and the presence of reflux esophagitis based on the Los Angeles classification.
Results:
A total of 340 patients were analyzed (mean age: 66.9±12.9 years) for a median follow-up of 55 months (interquartile range: 29.8-89.3). At the initial endoscopic assessment, 187 patients (55%) had a hiatal hernia, and all patients had gastric atrophy (C-1: 2%, C-2,3: 47%, O-1,2,3: 51%). Reflux esophagitis was detected in 7 patients (2%) before eradication and in 21 patients (6%) afterward, which was a significant increase (P=0.007). Barrett's esophagus was identified in 69 patients (20%) before eradication, with a median length of C0M1. Elongation after treatment was observed in only 2 patients (0.6%). We observed no significant increase in either the prevalence (P=0.85) or the median length (P=0.5) of Barrett’s esophagus.
Conclusions:
Only 0.6% of patients exhibited Barrett's esophagus lengthening after Helicobacter pylori eradication therapy, suggesting no significant impact of the treatment on the development or elongation of Barrett's esophagus.

引言：幽门螺杆菌（Helicobacter pylori）根除治疗可能加重胃食管反流病，而该疾病是巴雷特食管（Barrett’s esophagus）的重要危险因素。然而，根除治疗与巴雷特食管之间的关联仍存在争议。本研究旨在评估幽门螺杆菌根除治疗对巴雷特食管长度变化的影响。
材料与方法：本研究对2004年至2017年间成功接受幽门螺杆菌根除治疗的连续性患者开展回顾性分析。依据布拉格C&M标准（Prague C&M criteria），对比根除治疗前后获取的内镜影像，评估巴雷特食管长度；同时参照洛杉矶分类（Los Angeles classification）判断反流性食管炎的发生情况。
结果：本研究共纳入340例患者进行分析，患者平均年龄为66.9±12.9岁，中位随访时间为55个月（四分位间距：29.8~89.3）。首次内镜评估时，187例（55%）患者合并食管裂孔疝，所有患者均存在胃萎缩（C-1型：2%，C-2、3型：47%，O-1、2、3型：51%）。根除治疗前检出反流性食管炎7例（2%），治疗后检出21例（6%），差异具有统计学意义（P=0.007）。根除治疗前检出巴雷特食管69例（20%），中位长度为C0M1。仅2例（0.6%）患者在治疗后观察到巴雷特食管长度延长。未发现巴雷特食管的患病率（P=0.85）或中位长度（P=0.5）存在显著升高。
结论：仅0.6%的患者在接受幽门螺杆菌根除治疗后出现巴雷特食管长度延长，提示该治疗对巴雷特食管的发生或病程进展中的长度增加无显著影响。