Are we Missing Barrett's Esophagus in Our Busy Endoscopy Practice? Improving Detection

IF 0.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
A. Dutta
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引用次数: 1

Abstract

Barrett's esophagus (BE) denotes the replacement of stratified squamous epithelium of esophagus by columnar epithelium. It is associated with a significantly increased risk of esophageal adenocarcinoma and hence patients with BE are advised endoscopic surveillance for early detection of dysplastic and neoplastic lesions. Esophageal cancer is the sixth most common cancer in terms of incidence and mortality in India. Around 15 to 25% of esophageal cancers are adenocarcinoma. BE is likely to be an important precursor of esophageal adenocarcinoma and we may be missing patients with BE in our busy endoscopy practice. The detection of BE may be improved by identifying high-risk groups, performing thorough endoscopic examination, and applying newer imaging techniques. The high-risk group includes patients with chronic gastroesophageal reflux disease, obesity, smoking, etc. During endoscopic examination, a careful assessment of the gastroesophageal junction and identification of important landmarks such as gastroesophageal junction and Z line are essential to detect BE. Management of BE depends on the detection of dysplasia and for this four quadrant mucosal biopsy is recommended every 1 to 2 cm. However, random biopsy samples only a small area of mucosa and advanced technologies for real-time detection of dysplasia and neoplasia may overcome this limitation. In this review, we discuss the current scenario of BE in India and ways to improve the detection of BE including dysplastic lesions.
在繁忙的内窥镜检查中,我们是否错过了巴雷特食管?改进检测
巴雷特食管(BE)是指用柱状上皮代替食管的复层鳞状上皮。它与食道腺癌的风险显著增加有关,因此建议BE患者进行内镜监测,以早期发现增生异常和肿瘤性病变。就发病率和死亡率而言,癌症是印度第六大最常见的癌症。大约15%到25%的食道癌是腺癌。BE可能是食管腺癌的重要前兆,在繁忙的内镜实践中,我们可能会错过BE患者。BE的检测可以通过识别高危人群、进行彻底的内镜检查和应用新的成像技术来提高。高危人群包括慢性胃食管反流病、肥胖、吸烟等患者。在内镜检查中,仔细评估胃食管交界处并识别重要标志物(如胃食管交界和Z线)对检测BE至关重要。BE的治疗取决于发育不良的检测,对于这种四象限粘膜活检,建议每1-2次进行一次 然而,只有小面积粘膜的随机活检样本和实时检测发育不良和肿瘤的先进技术可能会克服这一限制。在这篇综述中,我们讨论了印度BE的现状,以及提高BE检测(包括发育异常病变)的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Digestive Endoscopy
Journal of Digestive Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
自引率
28.60%
发文量
35
审稿时长
22 weeks
期刊介绍: The Journal of Digestive Endoscopy (JDE) is the official publication of the Society of Gastrointestinal Endoscopy of India that has over 1500 members. The society comprises of several key clinicians in this field from different parts of the country and has key international speakers in its advisory board. JDE is a double-blinded peer-reviewed, print and online journal publishing quarterly. It focuses on original investigations, reviews, case reports and clinical images as well as key investigations including but not limited to cholangiopancreatography, fluoroscopy, capsule endoscopy etc.
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