Labenz J
Innere Medizin, Diakonie Klinikum, Jung-Stilling-Krankenhaus Siegen, Wichernstr. 40, 57074, Siegen, Deutschland.
Internist (Berl). 2016 Nov;57(11):1079-1092. doi: 10.1007/s00108-016-0152-5.
Barrett's esophagus is an endoscopically visible metaplasia of the columnar epithelium in the esophagus with histological detection of a specialized intestinal metaplasia. The circumferential and longitudinal extent are described endoscopically using the Prague classification. Barrett's esophagus mostly occurs as the result of gastroesophageal reflux disease. The risk of developing esophageal adenocarcinoma is increased but the absolute risk is low with 0.10-0.15 % per year. According to guideline recommendations, screening for Barrett's esophagus as well as endoscopic and biopsy surveillance should be limited to high risk groups. On detection of intraepithelial neoplasia (IEN) endoscopic therapy is indicated, whereby a second opinion must be obtained from a specialized pathologist for low-grade IEN. The influence of proton pump inhibitors on the progression to carcinoma is controversially discussed and a preventive anti-reflux operation is not indicated.
巴雷特食管是一种在内镜下可见的食管柱状上皮化生，经组织学检查可发现特殊的肠化生。其周向和纵向范围通过布拉格分类法在内镜下进行描述。巴雷特食管大多由胃食管反流病引起。发生食管腺癌的风险增加，但绝对风险较低，每年为0.10 - 0.15%。根据指南建议，巴雷特食管的筛查以及内镜和活检监测应仅限于高危人群。检测到上皮内瘤变（IEN）时，应进行内镜治疗，对于低级别IEN，必须获得专业病理学家的二次诊断意见。质子泵抑制剂对癌进展的影响存在争议，不建议进行预防性抗反流手术。
