Rastogi Amit, Sharma Prateek
Dr. Rastogi is Assistant Professor of Medicine and Dr. Sharma is Associate Professor of Medicine with the Department of Gastroenterology and Hepatology at the University of Kansas School of Medicine in Kansas City, Kan. The authors are also affiliated with the Veterans Affairs Medical Center, in Kansas City, Mo.
Gastroenterol Hepatol (N Y). 2006 Feb;2(2):134-139.
Barrett's esophagus is a known risk factor for the development of adenocarcinoma of the esophagus and esophagogastric junction. Based on the length of the columnar segment at endoscopy, Barrett's esophagus has been arbitrarily separated into two broad categories: long-segment and short-segment. The rapid rise in the incidence of esophageal adenocarcinoma has generated sustained research interest in this lesion. Studies have shown that although the prevalence of short-segment Barrett's esophagus is higher than that of long-segment Barrett's esophagus, the risk of developing dysplasia and adenocarcinoma may actually be lower in those patients with short segment Barrett's esophagus. Nonetheless, both dysplasia and esophageal adenocarcinoma have been reported in patients with short-segment Barrett's esophagus, making this arbitrary distinction clinically unimportant. The current surveillance guidelines remain the same for both short- and long-segment Barrett's esophagus. Another key issue is differentiating short-segment Barrett's esophagus from intestinal metaplasia of the gastric cardia. The latter is distinct from esophageal intestinal metaplasia (ie, Barrett's esophagus) and probably does not warrant surveillance.
巴雷特食管是食管腺癌和食管胃交界腺癌发生的已知危险因素。根据内镜检查时柱状上皮段的长度，巴雷特食管被人为地分为两大类：长段型和短段型。食管腺癌发病率的迅速上升引发了对该病变的持续研究兴趣。研究表明，尽管短段型巴雷特食管的患病率高于长段型巴雷特食管，但短段型巴雷特食管患者发生发育异常和腺癌的风险实际上可能更低。尽管如此，短段型巴雷特食管患者中也有发育异常和食管腺癌的报道，这使得这种人为的区分在临床上并不重要。目前，短段型和长段型巴雷特食管的监测指南是相同的。另一个关键问题是区分短段型巴雷特食管与贲门肠化生。后者与食管肠化生（即巴雷特食管）不同，可能不需要监测。
