Haidry Rehan, Lovat Laurence
aDepartment of Gastroenterology and Endoscopy, University College Hospital NHS Foundation Trust bDivision of Surgery and Interventional Science, Research Department for Tissue and Energy, University College London, UCL Hospitals NHS Foundation, London, UK.
Curr Opin Gastroenterol. 2015 Jul;31(4):316-20. doi: 10.1097/MOG.0000000000000190.
Here, we examine data on the long-term durability of endoscopic therapy in patients with mucosal neoplasia in Barrett's esophagus.
Short-term success is seen in most patients undergoing endoscopic therapy for Barrett's esophagus neoplasia, but long-term outcomes are only just becoming available.
The incidence of esophageal adenocarcinoma (EAC) continues to rise with poor survival seen in the majority of patients. The only known precursor to EAC is Barrett's esophagus. Although the risk of progression from metaplastic Barrett's esophagus to neoplasia is low, surveillance is advocated as patients who progress to mucosal neoplasia carry a significantly higher risk of progressing to invasive EAC. Minimally invasive endoscopic therapy with endoscopic resection and radiofrequency ablation are now the gold standard treatments for patients with intramucosal neoplasia in Barrett's esophagus. After successful treatment, follow-up is still required as long-term durability is not 100% and recurrences are not rare. This review highlights the need for vigilant follow-up, but emphasizes the consensus that most patients have durable disease reversal.
在此，我们研究了内镜治疗巴雷特食管黏膜瘤患者的长期疗效数据。
大多数接受巴雷特食管瘤内镜治疗的患者短期内取得了成功，但长期结果才刚刚可得。
食管腺癌（EAC）的发病率持续上升，大多数患者的生存率较低。EAC唯一已知的前体是巴雷特食管。虽然从化生的巴雷特食管进展为肿瘤的风险较低，但由于进展为黏膜瘤的患者进展为浸润性EAC的风险显著更高，因此提倡进行监测。内镜切除和射频消融等微创内镜治疗现在是巴雷特食管黏膜内瘤患者的金标准治疗方法。成功治疗后，仍需要进行随访，因为长期疗效并非100%，复发并不罕见。本综述强调了需要进行警惕的随访，但也强调了大多数患者疾病得到持久逆转的共识。
