Inadomi John M, Saxena Nina
Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
Transl Gastroenterol Hepatol. 2018 Dec 6;3:102. doi: 10.21037/tgh.2018.11.09. eCollection 2018.
The incidence of esophageal adenocarcinoma (EAC) is rising and the only known precursor of this disease is Barrett's esophagus (BE). EAC mortality remains high, prompting strategies to screen individuals with gastroesophageal reflux disease (GERD) symptoms to identify BE and conduct surveillance in order to detect neoplasia at a stage that is amenable to cure. The effectiveness of endoscopic eradication therapy has been improving with reduced harms, yet it is unclear which patients will benefit from this procedure. This chapter reviews the evidence supporting surveillance for BE to reduce mortality from EAC and combines these results with economic analyses to identify the optimal means to manage patients with BE with high-grade dysplasia, low-grade dysplasia, or no dysplasia.
食管腺癌（EAC）的发病率正在上升，而这种疾病唯一已知的前驱病变是巴雷特食管（BE）。EAC的死亡率仍然很高，这促使人们采取策略，对有胃食管反流病（GERD）症状的个体进行筛查，以识别BE并进行监测，以便在可治愈阶段检测到肿瘤形成。内镜下根除治疗的有效性在不断提高，危害也在减少，但尚不清楚哪些患者将从该手术中获益。本章回顾了支持对BE进行监测以降低EAC死亡率的证据，并将这些结果与经济分析相结合，以确定管理高级别异型增生、低级别异型增生或无异型增生的BE患者的最佳方法。
