Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Dig Endosc. 2014 May;26(3):311-21. doi: 10.1111/den.12294.
Barrett's esophagus (BE) is a metaplastic condition that occurs secondary to gastroesophageal reflux disease. BE is also a precursor to esophageal adenocarcinoma, which, although still rare in Japan, is one of the most rapidly increasing cancers in Western countries. However, the prevalence of gastroesophageal reflux disease has increased significantly over the past few decades in Japan, possibly leading to an incremental rise in BE and the associated inherent risk of adenocarcinoma. Given the poor prognosis of advanced-stage Barrett's adenocarcinoma, endoscopic surveillance is recommended for subjects with BE to detect early neoplasias including dysplasia. However, endoscopic identification of dysplastic lesions is still not sufficiently reliable or subjective, making targeted therapy extremely difficult. Over the past few years, improvements in image resolution, image processing software, and optical filter technology have enabled identification of dysplasia and early cancer in BE patients. We retrieved as many studies on advanced endoscopic technologies in BE as possible from MEDLINE and PubMed. The present review focuses on the emergent clinically available technologies to provide an overview of the technologies, their practical applicability, current status, and future challenges.
巴雷特食管（BE）是一种化生状态，继发于胃食管反流病。BE 也是食管腺癌的前体，尽管在日本仍然很少见，但它是西方国家发病率增长最快的癌症之一。然而，在过去几十年中，日本的胃食管反流病患病率显著增加，这可能导致 BE 的递增和相关腺癌的固有风险增加。鉴于晚期 Barrett 腺癌的预后不良，建议对 BE 患者进行内镜监测，以检测包括异型增生在内的早期肿瘤。然而，内镜识别异型增生病变仍然不够可靠或主观，使得靶向治疗极其困难。在过去的几年中，图像分辨率、图像处理软件和光学滤光片技术的改进使得能够识别 BE 患者的异型增生和早期癌症。我们从 MEDLINE 和 PubMed 中检索了尽可能多的关于 BE 中先进内镜技术的研究。本综述重点介绍了新兴的临床可用技术，以提供对这些技术、其实用适用性、现状和未来挑战的概述。
