Xian Wa, McKeon Frank
Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas and the Department of Biochemistry and Molecular Biology, University of Texas McGovern Medical School, Houston, Texas.
Department of Biology and Biochemistry, University of Houston, Houston, Texas, and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Cell Mol Gastroenterol Hepatol. 2017 Apr 26;4(1):161-164. doi: 10.1016/j.jcmgh.2017.04.005. eCollection 2017 Jul.
Although metaplasias have always attracted because of their strangeness, it is now clear they represent precursors for some of the most intractable human cancers. Despite this notoriety, they remain curiously understudied, and even their origins have been the subject of acrimonious debate stretching back to Virchow in the 19th century. Barrett's esophagus, with its high incidence, easy endoscopic access, and strong link to esophageal adenocarcinoma, would seem an ideal opportunity to address the origin problem. However, the field has settled into an uneasy status quo marked by no fewer than 4 parallel hypotheses, each of which is said to suffer fatal flaws. We favor one of these deficient hypotheses, that Barrett's arises from a distinct lineage of junctional cells present in all normal individuals, and discuss efforts to shore it up. It will be important to resolve this dialectic so that preemptive strategies for the eradication of Barrett's can reach patient care.
尽管化生因其奇特之处一直备受关注，但现在很清楚，它们是一些最难治疗的人类癌症的前体。尽管有这种恶名，但它们仍然奇怪地未得到充分研究，甚至其起源自19世纪的魏尔啸以来一直是激烈争论的主题。巴雷特食管发病率高、易于内镜检查且与食管腺癌有很强的联系，似乎是解决起源问题的理想机会。然而，该领域已陷入一种不稳定的现状，至少有4种并行的假说，据说每种假说都存在致命缺陷。我们支持这些有缺陷的假说中的一种，即巴雷特食管起源于所有正常个体中都存在的一种独特的交界细胞谱系，并讨论了支持这一假说的努力。解决这一辩证法很重要，以便根除巴雷特食管的先发制人策略能够应用于患者护理。
