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胃食管反流病和 Barrett 食管:概述及组织学诊断方法。

Gastro-esophageal reflux disease and Barrett's esophagus: an overview with an histologic diagnostic approach.

机构信息

Anatomic Pathology, San Martino IRCCS Hospital, Genova, Italy.

Anatomic Pathology, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Italy.

出版信息

Pathologica. 2020 Sep;112(3):117-127. doi: 10.32074/1591-951X-162.


DOI:10.32074/1591-951X-162
PMID:33179616
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7931578/
Abstract

The first part of this overview on non-neoplastic esophagus is focused on gastro-esophageal reflux disease (GERD) and Barrett's esophagus. In the last 20 years much has changed in histological approach to biopsies of patients with gastro-esophageal reflux disease. In particular, elementary histologic lesions have been well defined and modality of evaluation and grade are detailed, their sensitivity and specificity has been evaluated and their use has been validated by several authors. Also if there is not a clinical indication to perform biopsies in patient with GERD, the diagnosis of microscopic esophagitis, when biopsies are provided, can be performed by following simple rules for evaluation which allow pathologists to make the diagnosis with confidence. On the other hand, biopsies are required for the diagnosis of Barrett's esophagus. This diagnosis is the synthesis of endoscopic picture (which has to be provided with the proper description on extent and with adequate biopsies number) and histologic pattern. The current guidelines and expert opinions for the correct management of these diagnosis are detailed.

摘要

本综述的第一部分重点介绍非肿瘤性食管,包括胃食管反流病(GERD)和 Barrett 食管。在过去的 20 年中,胃食管反流病患者活检的组织学方法发生了很大变化。特别是,基本的组织学病变已经得到了很好的定义,评估和分级的方式也很详细,其敏感性和特异性已经得到了多位作者的评估和验证。尽管对于 GERD 患者没有进行活检的临床指征,但当提供活检时,可以通过遵循简单的评估规则来诊断微观食管炎,这使得病理学家能够有信心做出诊断。另一方面,活检是诊断 Barrett 食管所必需的。该诊断是内镜图像(必须提供适当的描述,包括范围和足够数量的活检)和组织学模式的综合。详细介绍了目前用于正确管理这些诊断的指南和专家意见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/945b6bd3eada/pathol-2020-03-117-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/b992ffaeee1f/pathol-2020-03-117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/053b520dce11/pathol-2020-03-117-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/945b6bd3eada/pathol-2020-03-117-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/b992ffaeee1f/pathol-2020-03-117-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/053b520dce11/pathol-2020-03-117-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/566b/7931578/945b6bd3eada/pathol-2020-03-117-g005.jpg

相似文献

[1]
Gastro-esophageal reflux disease and Barrett's esophagus: an overview with an histologic diagnostic approach.

Pathologica. 2020-9

[2]
[The influence of Barrett's esophagus on the clinical signs and postoperative results of GERD].

Zentralbl Chir. 2004-4

[3]
The diagnosis and management of Barrett's esophagus.

Adv Surg. 1999

[4]
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[5]
Diagnosis and Management of Low-Grade Dysplasia in Barrett's Esophagus: Expert Review From the Clinical Practice Updates Committee of the American Gastroenterological Association.

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[6]
Proinflammatory cytokine and nuclear factor kappa-B expression along the inflammation-metaplasia-dysplasia-adenocarcinoma sequence in the esophagus.

Am J Gastroenterol. 2005-6

[7]
The histologic squamo-oxyntic gap: an accurate and reproducible diagnostic marker of gastroesophageal reflux disease.

Am J Surg Pathol. 2010-11

[8]
Detailed esophageal function and morphological analysis shows high prevalence of gastroesophageal reflux disease and Barrett's esophagus in patients with cervical inlet patch.

Dis Esophagus. 2011-11-22

[9]
[Barrett's esophagus].

Chirurg. 2005-3

[10]
[Diagnosis of gastroesophageal reflux and Barrett esophagus].

Zentralbl Chir. 2000

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World J Gastrointest Surg. 2025-6-27

[2]
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[3]
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World J Clin Cases. 2022-9-16

[4]
Expression of VEGF, EGF, and Their Receptors in Squamous Esophageal Mucosa, with Correlations to Histological Findings and Endoscopic Minimal Changes, in Patients with Different GERD Phenotypes.

Int J Environ Res Public Health. 2022-4-27

[5]
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本文引用的文献

[1]
Intestinal metaplasia of the gastric cardia: findings in patients with versus without Barrett's esophagus.

Gastrointest Endosc. 2018-11-14

[2]
How to use Rome IV criteria in the evaluation of esophageal disorders.

Curr Opin Gastroenterol. 2018-7

[3]
Diagnosis and Endoscopic Management of Barrett's Esophagus: an Italian Experts' Opinion based document.

Dig Liver Dis. 2017-9-1

[4]
The dynamics of the oesophageal squamous epithelium 'normalisation' process in patients with gastro-oesophageal reflux disease treated with long-term acid suppression or anti-reflux surgery.

Aliment Pharmacol Ther. 2017-3-21

[5]
The Use of Ancillary Stains in the Diagnosis of Barrett Esophagus and Barrett Esophagus-associated Dysplasia: Recommendations From the Rodger C. Haggitt Gastrointestinal Pathology Society.

Am J Surg Pathol. 2017-5

[6]
Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis.

Gut. 2017-2-23

[7]
Epithelial Thickness is a Marker of Gastroesophageal Reflux Disease.

Clin Gastroenterol Hepatol. 2016-6-29

[8]
Asia-Pacific consensus on the management of gastro-oesophageal reflux disease: an update focusing on refractory reflux disease and Barrett's oesophagus.

Gut. 2016-6-3

[9]
Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV.

Gastroenterology. 2016-2-19

[10]
Do Ancillary Studies Aid Detection and Classification of Barrett Esophagus?

Am J Surg Pathol. 2016-8

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