Tytgat G N, Hameeteman W
Department of Hepatogastroenterology, University of Amsterdam, The Netherlands.
World J Surg. 1992 Mar-Apr;16(2):308-12. doi: 10.1007/BF02071538.
Reflux of gastric contents is the most important factor contributing to the development of a columnar-lined esophagus (CLE). CLE should be considered a "mosaic" of cells, glands, and architectural types showing variable degrees of maturation towards intestinal and gastric epithelium. Dysplasia refers to an unequivocally neoplastic alteration in the epithelium. High-grade (severe) dysplasia consists of neoplastic cellular and/or architectural changes within the columnar epithelium, without invasion through the basement membrane. The prevalence of dysplasia is usually 5% to 10%. Dysplasia has been found in the vast majority in the specialized columnar-type or intestinal-type epithelium. Adenocarcinoma in CLE is most often seen in males. At the time of diagnosis transmural tumor infiltration is found in 60% to 88% of patients, and lymph node invasion in 55% to 74% of patients. The prognosis is poor with a low 5 year survival. Estimates of incidence of cancer vary from 1 case per 52 patients years of follow-up to 1 case per 441 patient years of follow-up.
胃内容物反流是导致柱状上皮食管（CLE）发生的最重要因素。CLE应被视为细胞、腺体和结构类型的“镶嵌体”，显示出向肠上皮和胃上皮不同程度的成熟。发育异常是指上皮中明确的肿瘤性改变。高级别（重度）发育异常由柱状上皮内的肿瘤性细胞和/或结构改变组成，无基底膜浸润。发育异常的发生率通常为5%至10%。绝大多数发育异常见于特殊柱状型或肠型上皮。CLE中的腺癌最常见于男性。诊断时，60%至88%的患者存在肿瘤透壁浸润，55%至74%的患者存在淋巴结浸润。预后较差，5年生存率较低。癌症发病率估计为每52患者年随访1例至每441患者年随访1例。
