Department of Internal Medicine, University of California, Riverside School of Medicine, 900 University Avenue, Riverside, CA 92521, USA.
Section of Gastroenterology, Loma Linda VA Healthcare System, 11201 Benton Street, 2A-38, Loma Linda, CA 92357, USA.
Gastroenterol Clin North Am. 2021 Dec;50(4):751-768. doi: 10.1016/j.gtc.2021.08.009. Epub 2021 Oct 6.
Barrett's esophagus (BE) is the precursor lesion for esophageal adenocarcinoma (EAC) development. Unfortunately, BE screening/surveillance has not provided the anticipated EAC reduction benefit. Noninvasive techniques are increasingly available or undergoing testing to screen for BE among those with/without known risk factors, and the use of artificial intelligence platforms to aid endoscopic screening and surveillance will likely become routine, minimizing missed cases or lesions. Management of high-grade dysplasia and intramucosal EAC is clear with endoscopic eradication therapy preferred to surgery. BE with low-grade dysplasia can be managed with removal of visible lesions combined with endoscopic eradication therapy or endoscopic surveillance at present.
巴雷特食管（BE）是食管腺癌（EAC）发展的癌前病变。不幸的是，BE 的筛查/监测并未带来预期的 EAC 减少益处。目前，越来越多的非侵入性技术可用于或正在测试，以筛查有/无已知危险因素的 BE，并且人工智能平台的使用将有助于内镜筛查和监测，这可能会成为常规操作，最大限度地减少漏诊病例或病变。高级别上皮内瘤变和黏膜内 EAC 的管理明确，首选内镜消除治疗而非手术。目前，低级别上皮内瘤变的 BE 可以通过切除可见病变并结合内镜消除治疗或内镜监测来进行管理。
