Kastelein Florine, Kuipers Ernst J
Erasmus Medisch Centrum, afd. Maag- Darm- Leverziekten, Rotterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(49):A5497.
Patients with Barrett's oesophagus have an increased risk of developing oesophageal adenocarcinoma; surveillance is therefore recommended for these patients. However, it has never been proven that Barrett surveillance is actually effective. A recent article in The American Journal of Gastroenterology shows that patients with Barrett's oesophagus with high-grade dysplasia had a lower risk of developing oesophageal adenocarcinoma when they had previous surveillance or endoscopic therapy. These results suggest that surveillance may improve survival of patients with Barrett's oesophagus. However, there is no convincing evidence that surveillance has an effect on mortality due to oesophageal adenocarcinoma. Although the absolute overall risk of developing oesophageal adenocarcinoma in Barrett's oesophagus is low, surveillance is important in the small group of patients with a high risk of neoplastic progression.
患有巴雷特食管的患者发生食管腺癌的风险增加；因此，建议对这些患者进行监测。然而，从未有证据证明巴雷特监测实际上是有效的。《美国胃肠病学杂志》最近的一篇文章表明，患有高级别异型增生的巴雷特食管患者在接受过先前监测或内镜治疗后，发生食管腺癌的风险较低。这些结果表明，监测可能会提高巴雷特食管患者的生存率。然而，没有令人信服的证据表明监测对食管腺癌导致的死亡率有影响。尽管巴雷特食管发生食管腺癌的绝对总体风险较低，但监测对一小部分肿瘤进展风险高的患者很重要。
