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从反流性食管炎到巴雷特食管和食管腺癌。

From reflux esophagitis to Barrett's esophagus and esophageal adenocarcinoma.

作者信息

Wang Rui-Hua

机构信息

Rui-Hua Wang, Department of Gastroenterology, Shanghai Jiao Tong University affiliated Sixth People's Hospital South Campus, Shanghai 201499, China.

出版信息

World J Gastroenterol. 2015 May 7;21(17):5210-9. doi: 10.3748/wjg.v21.i17.5210.

Abstract

The occurrence of gastroesophageal reflux disease is common in the human population. Almost all cases of esophageal adenocarcinoma are derived from Barrett's esophagus, which is a complication of esophageal adenocarcinoma precancerous lesions. Chronic exposure of the esophagus to gastroduodenal intestinal fluid is an important determinant factor in the development of Barrett's esophagus. The replacement of normal squamous epithelium with specific columnar epithelium in the lower esophagus induced by the chronic exposure to gastroduodenal fluid could lead to intestinal metaplasia, which is closely associated with the development of esophageal adenocarcinoma. However, the exact mechanism of injury is not completely understood. Various animal models of the developmental mechanisms of disease, and theoretical and clinical effects of drug treatment have been widely used in research. Recently, animal models employed in studies on gastroesophageal reflux injury have allowed significant progress. The advantage of using animal models lies in the ability to accurately control the experimental conditions for better evaluation of results. In this article, various modeling methods are reviewed, with discussion of the major findings on the developmental mechanism of Barrett's esophagus, which should help to develop better prevention and treatment strategies for Barrett's esophagus.

摘要

胃食管反流病在人群中很常见。几乎所有食管腺癌病例都源于巴雷特食管,而巴雷特食管是食管腺癌癌前病变的一种并发症。食管长期暴露于胃十二指肠肠液中是巴雷特食管发生发展的一个重要决定因素。长期暴露于胃十二指肠液导致食管下段正常鳞状上皮被特定柱状上皮取代,可引发肠化生,这与食管腺癌的发生密切相关。然而,确切的损伤机制尚未完全明确。疾病发生发展机制的各种动物模型以及药物治疗的理论和临床效果已广泛应用于研究中。近年来,用于胃食管反流损伤研究的动物模型取得了显著进展。使用动物模型的优势在于能够精确控制实验条件,以便更好地评估结果。本文综述了各种建模方法,并讨论了巴雷特食管发生发展机制的主要研究结果,这有助于制定更好的巴雷特食管预防和治疗策略。

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