Bernstein I T, Kruse P, Andersen I B
Surgical Gastroenterologic Department, Copenhagen University Hospital, Hvidovre, Denmark.
Dig Dis. 1994 Mar-Apr;12(2):98-105. doi: 10.1159/000171442.
Barrett's oesophagus is defined as the occurrence of columnar epithelium extending for more than 3 cm up into the tubular part of the oesophagus. The average age at the time of diagnosis is 55 years. The condition is most often seen in men and is rare among negroid populations. The condition is caused by a combination of pronounced gastro-oesophageal reflux, hypersecretion of acid by the stomach, motoric and sensory dysfunction in the oesophagus, as well as increased aggressiveness of the refluxed material. The diagnosis is made by endoscopy, taking biopsies. Three types of histological epithelium occur: specialized columnar epithelium, junctional-type epithelium and gastric fundus-type epithelium. Barrett's oesophagus is a premalignant condition. Severe dysplasia is correlated with the development of oesophageal adenocarcinoma. The incidence of the latter varies between 1:441 and 1:52 per patient-year. The treatment of Barrett's oesophagus is either medical treatment or surgery. The medical treatment includes H2 receptor antagonists or omeprazole. Antireflux surgery is indicated in cases resistant to medical treatment. Resection is the only possible curative treatment when severe dysplasia or adenocarcinoma is present. Recommendations are made, based on the available literature, as to the treatment and follow-up of patients with Barrett's oesophagus.
巴雷特食管的定义为柱状上皮向上延伸至食管管状部分超过3厘米。诊断时的平均年龄为55岁。这种情况最常见于男性，在黑人人群中较为罕见。它是由明显的胃食管反流、胃酸过度分泌、食管运动和感觉功能障碍以及反流物质的侵袭性增加共同引起的。通过内镜检查并取活检进行诊断。存在三种组织学类型的上皮：特殊柱状上皮、交界型上皮和胃底型上皮。巴雷特食管是一种癌前病变。重度发育异常与食管腺癌的发生相关。后者的发病率在每位患者每年1:441至1:52之间。巴雷特食管的治疗方法包括药物治疗或手术治疗。药物治疗包括H2受体拮抗剂或奥美拉唑。抗反流手术适用于对药物治疗耐药的病例。当存在重度发育异常或腺癌时，切除是唯一可能的治愈性治疗方法。基于现有文献，对巴雷特食管患者的治疗和随访提出了建议。
