Predictive Ability for Reflux Esophagitis by Gastroesophageal Barium Reflux and Angle of His Seen in Upper Gastrointestinal Series

抄録

Objective: This study aimed to examine the ability of barium-confirmed gastroesophageal reflux and the angle of His assessed using upper gastrointestinal series (UGIS) to predict the presence of reflux esophagitis (RE).

Design: A total of 1,628 middle-aged Japanese individuals who underwent a radiographic and endoscopic examination between January 2000 and December 2012 were recruited.

Methods: The receiver operating characteristic (ROC) curves and the area under the curves (AUCs) were used for RE diagnosis according to barium reflux, the angle of His, and their combination. The predictive sensitivity, specificity, and the Youden index were calculated according to the combination of the two indices, and the maximum value of the Youden index was considered as the optimal cutoff value for RE diagnosis.

Results: ROC analysis was performed to estimate the optimal cutoff values of the Youden index for barium reflux and the angle of His. The AUCs for RE diagnosis according to barium reflux, the angle of His, and their combination were 0.76, 0.64, and 0.80, respectively. The optimal cutoff value was an angle of His of 45-46° with barium reflux. The sensitivity, specificity, and the Youden index were 76.3%, 80.4%, and 0.56, respectively.

Conclusion: Our results suggest that barium reflux and the angle of His assessed using UGIS are useful for an early diagnosis of RE.