Improving Dysplasia Detection in Barrett's Esophagus

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-01-01 DOI:10.1016/j.tige.2023.01.002

Erik A. Holzwanger , Alex Y. Liu , Prasad G. Iyer

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Abstract

The incidence of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) continues to increase in Western countries, and EAC continues to have an overall 5-year survival rate of less than 20%. This is predominantly due to most EAC cases being diagnosed at advanced stages, after the onset of alarm symptoms. The rationale behind endoscopic surveillance of BE follows the paradigm that metaplasia (BE) progresses to EAC via the development of low- (LGD) and then high-grade dysplasia (HGD). Hence, endoscopic surveillance is recommended to enable early detection of dysplasia and EAC. Numerous endoscopic eradication therapy (EET) modalities, such as radiofrequency ablation (RFA), cryotherapy, and endoscopic resection, enable effective treatment of dysplasia and early-stage EAC. Indeed, randomized trials have conclusively shown that endoscopic treatment of BE-HGD and BE-LGD with RFA reduces progression to EAC. Additionally, EET effectively treats early-stage EAC.

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改善Barrett食管异常增生检出率

Barrett食管（BE）和食管腺癌（EAC）的发病率在西方国家持续增加，EAC的5年生存率仍低于20%。这主要是由于大多数EAC病例是在出现警报症状后的晚期诊断的。BE内镜监测的基本原理遵循这样一种范式，即化生（BE）通过低（LGD）和高级别发育不良（HGD）发展为EAC。因此，建议进行内镜监测，以便早期发现发育不良和EAC。许多内镜根除治疗（EET）方式，如射频消融（RFA）、冷冻治疗和内镜切除，能够有效治疗发育不良和早期EAC。事实上，随机试验已经最终表明，内镜下用RFA治疗BE-HGD和BE-LGD可以减少EAC的进展。此外，EET有效治疗早期EAC。

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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.