Barrett食管生物标志物在风险分层方面的研究现状和挑战

Current Status and Challenges of Research on Biomarkers of Barrett’s Esophagus in Risk Stratification

Barrett食管(BE)被公认为食管腺癌(EAC)的癌前病变和最强风险因素,其漏诊率高,恶变为EAC后生存率低,且当前监测方法和治疗手段等均较为有限。因此,筛查BE的生物标志物被寄予厚望,尤其是BE恶变进展风险分层生物标志物有助于早期、快速、准确判断疾病进程,指导BE患者分层管理和精准治疗,降低恶变率和死亡率。本文以肿瘤内异质性的动态进化过程为主线,从遗传学、表观遗传学和血清学角度切入,综述BE生物标志物在风险分层方面的研究现状和挑战。

Barrett’s esophagus(BE)is the recognized precancerous lesion and risk factor for esophageal adenocarcinoma(EAC),and has a high miss diagnosis rate and low survival rate when malignantly transformed into EAC,moreover,there are only limited monitoring method and treatment.Therefore,the screening of biomarkers is highly expected,especially the risk stratification biomarkers related to the progression of malignant transformation of BE.Such biomarkers can help to determine early,quickly and accurately the disease process,and guide the stratified management and precise treatment of BE,reduce the malignancy rate and mortality.This article focused on the dynamic evolutionary process of intra‑tumor heterogeneity,and reviewed the current status and challenges of research on BE biomarkers in risk stratification from the genetics,epigenetics and serology perspectives.