Triadafilopoulos George, Friedland Shai
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Transl Gastroenterol Hepatol. 2018 Sep 17;3:67. doi: 10.21037/tgh.2018.09.10. eCollection 2018.
Modern recognition and management of Barrett's esophagus, a precursor to esophageal adenocarcinoma depends on diagnostic accuracy, risk assessment, technical expertise and consideration of many options to best tailor therapy for every patient. Concomitant management of acid reflux is essential, frequently with proton pump inhibitors. Ablation and resection favorably affect the evolution towards cancer. Using precision medicine tools, such as imaging, molecular diagnostics and analytics may lead to cost- and comparatively-effective therapies ultimately aiming at cancer prevention. Knowledge of the risk factors for Barrett's esophagus and progression to dysplasia and cancer can help tailor a precision medicine approach with more aggressive screening and surveillance targeted at patients that are most likely to benefit.
巴雷特食管是食管腺癌的癌前病变，现代对其的认识与管理取决于诊断准确性、风险评估、技术专长以及对多种选择的考量，以便为每位患者量身定制最佳治疗方案。同时，对胃酸反流的管理至关重要，通常需使用质子泵抑制剂。消融和切除对癌症的发展有积极影响。运用精准医学工具，如成像、分子诊断和分析，最终可能带来成本效益高的疗法，目标是预防癌症。了解巴雷特食管的风险因素以及向发育异常和癌症进展的情况，有助于针对最可能受益的患者制定更积极的筛查和监测方案，从而量身定制精准医学方法。
