Improving Dysplasia Detection in Barrett's Esophagus

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy 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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引用次数: 0

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

Techniques and Innovations in Gastrointestinal Endoscopy Medicine-Gastroenterology

CiteScore

2.10

自引率

50.00%

发文量