Kristo I, Asari R, Rieder E, Riegler V, Schoppmann S F
Department of Surgery, Medical University of Vienna, Vienna, Austria -
Minerva Chir. 2015 Apr;70(2):107-18. Epub 2015 Feb 3.
Barrett's esophagus represents a premalignant condition, which is strongly associated with the incidence of esophageal adenocarcinoma. Currently, there are no validated markers to extract exactly that certain patient that will proceed to neoplastic progression. Therefore, therapeutic options have to include a larger population to provide prophylaxis for affected patients. Recently developed endoscopic therapeutic approaches offer treatment options for prevention or even treatment of limited esophageal adenocarcinoma. At present, high eradication rates of intestinal metaplasia as well as dysplasia are observed, whereas low complication rates offer a convenient safety profile. These striking new methods symbolize a changing paradigm in a field, where minimal-invasive tissue ablating methods and tissue preserving techniques have led to modified regimens. This review will focus on current standards and newly emerging methods to treat Barrett's esophagus and its progression to cancer and will highlight their evolution, potential benefits and their limitations.
巴雷特食管是一种癌前病变，与食管腺癌的发病率密切相关。目前，尚无经过验证的标志物来准确识别哪些特定患者会发生肿瘤进展。因此，治疗方案必须涵盖更多人群，为受影响的患者提供预防措施。最近开发的内镜治疗方法为预防甚至治疗局限性食管腺癌提供了治疗选择。目前，观察到肠化生和发育异常的根除率较高，而并发症发生率较低，安全性良好。这些引人注目的新方法标志着该领域范式的转变，在这个领域中，微创组织消融方法和组织保留技术带来了治疗方案的改变。本综述将重点关注治疗巴雷特食管及其癌变进展的当前标准和新出现的方法，并将突出它们的演变、潜在益处及其局限性。
