迈向巴雷特食管筛查:现行指南、成像方式及未来发展
Towards screening Barrett's oesophagus: current guidelines, imaging modalities and future developments.
作者信息
Maitra Ishaan, Date Ravindra Sudhachandra, Martin Francis Luke
机构信息
School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, UK.
Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
出版信息
Clin J Gastroenterol. 2020 Oct;13(5):635-649. doi: 10.1007/s12328-020-01135-2. Epub 2020 Jun 3.
Barrett's oesophagus is the only known precursor to oesophageal adenocarcinoma (OAC). Although guidelines on the screening and surveillance exist in Barrett's oesophagus, the current strategies are inadequate. Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrett's oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrett's oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrett's oesophagus. Imaging modalities applicable to this condition are discussed, in addition to future developments. There is an urgent need for an alternative non-invasive method of screening and/or surveillance which could be highly beneficial towards reducing waiting times, alleviating patient fears and reducing future costs in current healthcare services. Vibrational spectroscopy has been shown to be promising in categorising Barrett's oesophagus through to high-grade dysplasia (HGD) and OAC. These techniques need further validation through multicentre trials.
巴雷特食管是已知的食管腺癌(OAC)唯一前驱病变。尽管存在关于巴雷特食管筛查和监测的指南,但目前的策略并不充分。食管胃十二指肠镜检查(OGD)是筛查巴雷特食管的金标准方法。这种侵入性方法成本高昂且存在相关风险,这使其无法用作巴雷特食管的当前筛查工具。本综述探讨了巴雷特食管目前的定义、流行病学、生物标志物、监测及筛查情况。除了未来的发展方向外,还讨论了适用于这种情况的成像方式。迫切需要一种替代性的非侵入性筛查和/或监测方法,这对于减少等待时间、减轻患者恐惧以及降低当前医疗服务的未来成本可能非常有益。振动光谱已显示出在对巴雷特食管直至高级别异型增生(HGD)和OAC进行分类方面具有前景。这些技术需要通过多中心试验进行进一步验证。
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