摘要
The incidence of esophageal adenocarcinoma(EAC)has markedly increased in the United States over the last few decades.Barrett’s esophagus(BE)is the most significant known risk factor for this malignancy.Theoretically,screening and treating early BE should help prevent EAC but the exact incidence of BE and its progression to EAC is not entirely known and costeffectiveness studies for Barrett’s screening are lacking.Over the last few years,there have been major advances in our understanding of the epidemiology,pathogenesis and endoscopic management of BE.These developments focus on early recognition of advanced histology and endoscopic treatment of high-grade dysplasia.Advanced resection techniques now enable us to endoscopically treat early esophageal cancer.In this review,we will discuss these recent advances in diagnosis and treatment of Barrett’s esophagus and early esophageal adenocarcinoma.
在过去几十年间,美国早期食管癌的发生率快速增长。Barrett食管是癌变最为显著的危险因素。理论上,Barrett食管的早期筛查和早期治疗有助于早期食管癌的预防,然而,Barrett食管及其恶性转化的发生率仍不甚清楚,而且也缺少Barrett食管筛查的成本-效应研究结果。过去几十年间,我们对Barrett食管流行病学特征、病理发生机制及内镜治疗方面的认识有了一些重大进展。这些进展主要集中在组织学进展的早期识别和高级别上皮内瘤变的内镜治疗。内镜切除技术的进步已使我们能够在内镜下治疗早期食管癌。本文将详细探讨Barrett食管和早期食管腺癌的诊治进展。
