Translation Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Translation Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Dig Liver Dis. 2018 Sep;50(9):871-877. doi: 10.1016/j.dld.2018.04.012. Epub 2018 Apr 22.
Current endoscopic surveillance protocols for Barrett's oesophagus have several limitations, mainly the poor cost-effectiveness and high miss rate. However, there is sufficient evidence that patients enrolled in a surveillance program have better survival chances of oesophageal cancer due to earlier tumor stages at diagnosis compared to patients with de novo diagnosed oesophagus cancer. Risk stratifications aim to identify patients at highest risk of developing adenocarcinoma of the oesophagus; most of them base on the length of the Barrett's segment and the presence of dysplasia. This review discusses prognostic factors and provides practical guidance on how to improve the efficacy and outcome in Barrett's surveillance programs.
目前 Barrett 食管的内镜监测方案存在一些局限性，主要是成本效益差和高漏诊率。然而，有充分的证据表明，与新诊断的食管癌患者相比，参加监测计划的患者由于诊断时肿瘤分期更早，因此具有更好的食管癌生存机会。风险分层旨在确定患食管腺癌风险最高的患者；其中大多数基于 Barrett 段的长度和异型增生的存在。本文讨论了预后因素，并就如何提高 Barrett 监测计划的效果和结果提供了实用指导。
