Dumoulin Franz Ludwig, Rodriguez-Monaco Fabian Dario, Ebigbo Alanna, Steinbrück Ingo
Department of Medicine and Gastroenterology, Gemeinschaftskrankenhaus Bonn, Academic Teaching Hospital, University of Bonn, Bonner Talweg 4-6, D-53113 Bonn, Germany.
Department of Gastroenterology, University Hospital Augsburg, Stenglinstr. 2, D-86156 Augsburg, Germany.
Cancers (Basel). 2022 Apr 10;14(8):1918. doi: 10.3390/cancers14081918.
Esophageal adenocarcinoma is increasing in incidence and is the most common subtype of esophageal cancer in Western societies. The stepwise progression of Barrett´s metaplasia to high-grade dysplasia and invasive adenocarcinoma provides an opportunity for screening and surveillance. There are important unresolved issues, which include (i) refining the definition of the screening population in order to avoid unnecessary invasive diagnostics, (ii) a more precise prediction of the (very heterogeneous) individual progression risk from metaplasia to invasive cancer in order to better tailor surveillance recommendations, (iii) improvement of the quality of endoscopy in order to reduce the high miss rate for early neoplastic lesions, and (iv) support for the diagnosis of tumor infiltration depth in order to guide treatment decisions. Artificial intelligence (AI) systems might be useful as a support to better solve the above-mentioned issues.
食管腺癌的发病率正在上升,并且是西方社会中最常见的食管癌亚型。巴雷特化生逐步发展为高级别异型增生和浸润性腺癌,为筛查和监测提供了机会。目前仍存在一些重要的未解决问题,其中包括:(i)完善筛查人群的定义,以避免不必要的侵入性诊断;(ii)更精确地预测(非常异质的)个体从化生发展为浸润性癌的进展风险,以便更好地制定监测建议;(iii)提高内镜检查质量,以降低早期肿瘤性病变的高漏诊率;(iv)辅助肿瘤浸润深度的诊断,以指导治疗决策。人工智能(AI)系统可能有助于更好地解决上述问题。