Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Curr Gastroenterol Rep. 2021 Oct 15;23(12):22. doi: 10.1007/s11894-021-00821-6.
Esophageal adenocarcinoma (EAC) is a lethal disease with rapidly rising incidence. Screening for EAC and its metaplastic precursor, Barrett's esophagus (BE), followed by endoscopic surveillance and endoscopic treatment of dysplasia or early EAC are promising approaches to decreasing EAC incidence and EAC mortality. Historically, screening for EAC has been completed with a traditional per-oral esophagogastroduodenoscopy (EGD); however, this method has limitations including cost, tolerability, and accessibility. For this reason, much effort has been put forward to develop more effective, minimally invasive, and accessible BE and EAC screening tools. The purpose of this review is to describe recent developments of these novel tools.
While endoscopic alternatives such as transnasal endoscopy are cheaper and well tolerated, they have not gained acceptance. Non-endoscopic modalities namely, swallowable cell collection devices coupled with biomarker analysis have been found to have excellent performance characteristics, tolerability, and cost effectiveness. In this article, we provide an update on innovative developments in EAC/BE screening modalities including transnasal endoscopy, capsule endomicroscopy, swallowable cell collection devices, and exhaled volatile organic compound analyses.
食管腺癌（EAC）是一种致命疾病，发病率迅速上升。对 EAC 及其化生前体 Barrett 食管（BE）进行筛查，然后对异型增生或早期 EAC 进行内镜监测和内镜治疗，是降低 EAC 发病率和死亡率的有前途的方法。从历史上看，EAC 的筛查是通过传统的经口食管胃十二指肠镜检查（EGD）完成的；然而，这种方法存在成本、耐受性和可及性方面的局限性。出于这个原因，人们付出了很大的努力来开发更有效、微创和更易获得的 BE 和 EAC 筛查工具。本综述的目的是描述这些新工具的最新进展。
虽然经鼻内镜等内镜替代方法更便宜且耐受性更好，但它们并未被广泛接受。非内镜方法，即结合生物标志物分析的吞咽细胞采集装置，已被证明具有出色的性能特征、耐受性和成本效益。在本文中，我们提供了 EAC/BE 筛查方式的创新发展的最新信息，包括经鼻内镜、胶囊内镜、吞咽细胞采集装置和呼气挥发性有机化合物分析。
