[Endo-brachy-esophagus, Jean-Louis Lortat-Jacob and Barrett's esophagus. The history of a modern disease].

The term-endo-brachy-oesophagus (EBO) became part of the specialised vocabulary of all those interested in the pathology of the esophagus at the beginning of the 1950s, when J. L. Lortat-Jacob identified the existence, in certain patients suffering from reflux, of the endo-esophageal ascent of a mucosa of gastric type, without any change in the gross topography of the gastro-esophageal junction. A similar lesion had been described at this same time in Great Britain by N. R. Barrett. Since then, numerous clinical and experimental arguments have been advanced in support of the acquired origin of this disorder, in the context of progressive gastro-esophageal reflux disease. However, the possibility of its regression after the treatment of reflux and its histologic presentation, though of major importance, remain unsettled. It is now generally acknowledged that EBO is one of the digestive lesions most prone to malignant degeneration, to the extent that it is now generally classified as precancerous, and all the most sophisticated procedures have been currently suggested and exploited in the attempt to detect EBO of potential malignancy. Within this field, ultramicroscopic study, enzyme assays and the techniques of flow cytometry are being used to better define this problem and to specify the point after which it is legitimate to abandon the medical treatment of reflux in favor of more aggressive methods, even surgical resection of the esophagus. The OESO Group, created in 1978, is currently conducting an international multidisciplinary and multicenter study to deal with the epidemiologic and therapeutic problems of this disorder.