Cengia G, Missale G, Minelli L, Villanacci V, Rossi E, Cestari R
Department of Surgery, University of Brescia, Spedali Civili, Brescia, Italy.
Dig Dis. 2007;25(3):197-202. doi: 10.1159/000103884.
Barrett's esophagus (BE) is a complication of chronic gastroesophageal reflux disease (GERD) and is the precursor of esophageal adenocarcinoma (EA), through a progression from intestinal metaplasia (IM), through high-grade dysplasia (HGD). Although the progression from BE to EA seems to be infrequent (0.5% per year), endoscopic and bioptic surveillance would play a significant role in the evaluation of HGD and the detection of EA in early, curable stage, improving survival rates after treatments. The severity and the duration of GERD could be helpful in the assessment of the risk for BE and to enroll these subjects into screening protocols to detect any dysplastic or neoplastic change. The benefits of screening-surveillance programs could be furthermore enhanced by an improvement in diagnostic methods, such as high-resolution endoscopic techniques and the use of biomarkers for the histological examination seems to play a primary role in the cancer risk stratification; in such way, endoscopic resection techniques (mucosal resection and submucosal dissection) can be considered as a helpful method to stage dysplastic changes in BE.
巴雷特食管（BE）是慢性胃食管反流病（GERD）的一种并发症，是食管腺癌（EA）的前驱病变，其发展过程是从肠化生（IM），再到高级别异型增生（HGD）。尽管从BE发展到EA的情况似乎并不常见（每年0.5%），但内镜检查和活检监测在评估HGD以及在早期可治愈阶段检测EA方面将发挥重要作用，从而提高治疗后的生存率。GERD的严重程度和持续时间有助于评估BE的风险，并将这些患者纳入筛查方案，以检测任何发育异常或肿瘤性变化。通过改进诊断方法，如高分辨率内镜技术，筛查监测项目的益处可以进一步提高，并且使用生物标志物进行组织学检查似乎在癌症风险分层中起主要作用；通过这种方式，内镜切除技术（黏膜切除和黏膜下剥离）可被视为对BE发育异常变化进行分期的一种有用方法。
