Sostres Carlos, Lacarta Pedro, Lanas Angel
Sección de Endoscopias Digestivas, Hospital Clínico Lozano Blesa, Zaragoza, España.
Gastroenterol Hepatol. 2013 Oct;36(8):520-6. doi: 10.1016/j.gastrohep.2012.11.010. Epub 2013 Mar 1.
Barrett's esophagus (BE) is the main recognized risk factor for the development of esophageal adenocarcinoma (EAC). The incidence of this cancer and its associated mortality has increased in developed countries during the last few years. Detection of EAC at earlier stages could potentially improve survival dramatically in these patients, which is especially important as mortality from EAC remains high despite the available treatments. Therefore, endoscopic surveillance is an attractive option for patients with Barrett's esophagus. Consequently, periodic endoscopic surveillance is recommended by all the International Gastroenterology Societies in an attempt to detect EAC at an early and potentially curable stage. Currently, the frequency of endoscopic surveillance and its need in Barrett's esophagus with low-grade dysplasia or without dysplasia are under discussion. This review presents the available evidence in order to assist clinicians in the decision-making process.
巴雷特食管(BE)是公认的食管腺癌(EAC)发生的主要危险因素。在过去几年中,这种癌症的发病率及其相关死亡率在发达国家有所上升。在早期阶段检测到EAC可能会显著提高这些患者的生存率,鉴于尽管有可用的治疗方法,但EAC的死亡率仍然很高,这一点尤为重要。因此,内镜监测对于巴雷特食管患者是一个有吸引力的选择。因此,所有国际胃肠病学会都建议进行定期内镜监测,以期在早期且可能治愈的阶段检测到EAC。目前,内镜监测的频率及其在低级别异型增生或无异型增生的巴雷特食管中的必要性正在讨论中。本综述提供现有证据,以协助临床医生进行决策。