Mansour Nabil M, El-Serag Hashem B, Anandasabapathy Sharmila
Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA.
Ann Cardiothorac Surg. 2017 Mar;6(2):75-87. doi: 10.21037/acs.2017.03.05.
Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes. Advanced endoscopic imaging can help increase the efficiency of current endoscopic surveillance. Endoscopic therapy is safe and effective for the treatment of dysplastic BE and intramucosal EAC, but ongoing surveillance following treatment is necessary. This review will cover screening, surveillance, advanced imaging, chemoprevention, endoscopic treatment, and post-treatment surveillance of BE.
巴雷特食管（BE）是一种癌前病变，会增加食管腺癌（EAC）的发病风险。在西方世界更为常见，危险因素包括年龄增长、男性、白种人、胃食管反流病（GERD）、中心性肥胖和吸烟。进展为癌症的发生率取决于巴雷特发育异常的分级。建议对患有GERD和其他危险因素的患者进行BE筛查。对BE患者进行内镜监测可能会改善总体预后。先进的内镜成像有助于提高当前内镜监测的效率。内镜治疗对于发育异常的BE和黏膜内EAC的治疗是安全有效的，但治疗后仍需持续监测。本综述将涵盖BE的筛查、监测、先进成像、化学预防、内镜治疗及治疗后监测。
