Division of Gastroenterology and Hepatology, Northwestern University, Chicago, Illinois.
Vatche and Tamar Manoukian Division of Digestive Diseases, University of California-Los Angeles, Los Angeles, California.
Gastroenterology. 2018 May;154(7):1861-1875.e1. doi: 10.1053/j.gastro.2017.12.045. Epub 2018 Feb 16.
Advances in endoscopic eradication therapy for Barrett's Esophagus-associated neoplasia have resulted in a significant paradigm shift in the diagnosis and management of this complex disease. A robust body of literature critically evaluating outcomes of resection and ablative strategies has allowed gastroenterologists to make quality, evidence-based decisions for their patients. Despite this progress, there are still many unanswered questions and challenges that remain. Ultimately, identification of a cost-effective screening modality, biomarkers for risk stratification, and strides to eliminate post surveillance endoscopy after endoscopic eradication therapy are essential to reach our long-term goal for eradication of esophageal adenocarcinoma.
内镜消除疗法在 Barrett 食管相关肿瘤治疗方面的进展,导致了该复杂疾病的诊断和治疗方式发生了重大转变。大量文献对切除和消融策略的结果进行了严格评估,使胃肠病学家能够为患者做出高质量、基于证据的决策。尽管取得了这些进展,但仍有许多悬而未决的问题和挑战。最终,确定一种具有成本效益的筛查方式、用于风险分层的生物标志物,以及消除内镜消除治疗后随访内镜检查,对于实现我们消除食管腺癌的长期目标至关重要。