巴雷特食管与黏膜内食管腺癌

Barrett Esophagus and Intramucosal Esophageal Adenocarcinoma.

作者信息

Rajendra Shanmugarajah, Sharma Prateek

机构信息

Sam Fayad Gastro-Intestinal Viral Oncology Group, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, Sydney, New South Wales 2170, Australia; Department of Gastroenterology & Hepatology, Bankstown-Lidcombe Hospital, South Western Sydney Local Health Network, 68-70, Eldridge Road, Bankstown, Sydney, New South Wales 2200, Australia.

Division of Gastroenterology and Hepatology, Veterans Affairs Medical Center, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, MO 66160, USA.

出版信息

Hematol Oncol Clin North Am. 2017 Jun;31(3):409-426. doi: 10.1016/j.hoc.2017.01.003. Epub 2017 Mar 22.

DOI:10.1016/j.hoc.2017.01.003

PMID:28501084

Abstract

Barrett esophagus (BE) is a precursor lesion for esophageal adenocarcinoma (EAC). Developments in imaging and molecular markers, and endoscopic eradication therapy, are available to curb the increase of EAC. Endoscopic surveillance is recommended, despite lack of data. The cancer risk gets progressively downgraded, raising questions about the understanding of risk factors and molecular biology involved. Recent data point to at least 2 carcinogenic pathways operating in EAC. The use of p53 overexpression and high-risk human papillomavirus may represent the best chance to detect progressors. Genome-wide technology may provide molecular signatures to aid diagnosis and risk stratification in BE.

摘要

巴雷特食管（BE）是食管腺癌（EAC）的一种前驱病变。影像学和分子标志物以及内镜下根除治疗方面的进展可用于遏制EAC的增加。尽管缺乏数据，但仍建议进行内镜监测。癌症风险逐渐降低，这引发了对所涉及的风险因素和分子生物学理解的质疑。最新数据表明，EAC中至少有2条致癌途径在起作用。使用p53过表达和高危型人乳头瘤病毒可能是检测进展期病例的最佳机会。全基因组技术可能会提供分子特征，以辅助BE的诊断和风险分层。