Am J Gastroenterol. 2013 Mar;108(3):363-5. doi: 10.1038/ajg.2012.455.
Symptoms of gastroesophageal reflux are the only commonly used criterion for endoscopic screening for esophageal adenocarcinoma (EAC). Recent research has elucidated multiple other risk factors for both EAC and Barrett's esophagus (BE). Utilization of these risk factors may allow for the selection of a screening population with a much higher pre-test probability of disease. A recently developed risk-prediction model for BE is a significant step in the right direction; however, further refinements in this model will likely be necessary to optimize utility. Our inability to prognosticate cancer risk in BE does temper enthusiasm for increasing the pool of patients under endoscopic surveillance for BE, and again highlights the need for better, cheaper, and more accurate means of stratifying cancer risk in BE.
胃食管反流病的症状是目前用于内镜筛查食管腺癌(EAC)的唯一常用标准。最近的研究已经阐明了 EAC 和巴雷特食管(BE)的多个其他危险因素。这些危险因素的利用可能会选择一个具有更高疾病先验概率的筛查人群。最近开发的 BE 风险预测模型是朝着正确方向迈出的重要一步;然而,为了优化该模型的实用性,可能还需要对其进行进一步的改进。我们无法预测 BE 中的癌症风险,这降低了增加接受 BE 内镜监测的患者群体的积极性,再次强调了需要更好、更便宜和更准确的方法来对 BE 中的癌症风险进行分层。