Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per...Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett’s esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett’s esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett’s esophagus and EA and to discuss what is required to move the field forward towards clinical application.展开更多
AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats un...AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated in rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence of esophagitis,Barrett's esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk (P < 0.01),being 96% and 100% (P > 0.05),88% and 82.4% (P > 0.05),20% and 52.1% (P < 0.05),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice.The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important prophylaxis for EAC.展开更多
AIM:To summarize the relationship between p.Tyr113His and p.His139Arg polymorphisms in microsomal epoxide hydrolase(EPHX1)and risk for esophageal cancer(EC).METHODS:The MEDLINE/PubMed and EMBASE databases were searche...AIM:To summarize the relationship between p.Tyr113His and p.His139Arg polymorphisms in microsomal epoxide hydrolase(EPHX1)and risk for esophageal cancer(EC).METHODS:The MEDLINE/PubMed and EMBASE databases were searched for studies of the association between EPHX1 polymorphisms and EC risk that were published from the database inception date to April2013.A total of seven case-control studies,including seven on p.Tyr113His(cases,n=1118;controls,n=1823)and six on p.His139Arg(cases,n=861;controls,n=1571),were included in the meta-analysis.After data extraction by two investigators working independently,the meta-analyses were carried out with STATA 11.0 software.Pooled odds ratios and 95%CI were calculated using a fixed-effects model or a random-effects model,as appropriate.RESULTS:The pooled EPHX1 p.Tyr113His polymorphism data showed no significant association with EC in any of the genetic models(OR=1.00,95%CI:0.70-1.48 for Tyr/His vs Tyr/Tyr;OR=1.10,95%CI:0.77-1.57 for His/His vs Tyr/Tyr;OR=1.06,95%CI:0.75-1.49 for a dominant model;OR=1.09,95%CI:0.89-1.34 for a recessive model).Similar results were obtained from the p.His139Arg polymorphism analysis(Arg/His vs His/His:OR=1.02,95%CI:0.84-1.23;Arg/Arg vs His/His:OR=0.96,95%CI:0.60-1.54;OR=1.03,95%CI:0.78-1.37 for the dominant model;OR=0.97,95%CI:0.61-1.56 for the recessive model).Subgroup analyses for ethnicity,subtype of EC,and source of controls(population-based or hospital-based)showed trends that were consistent with the pooled analysis(reported above),with no significant associations found.CONCLUSION:This meta-analysis suggests that the p.Tyr113His and p.His139Arg polymorphisms in EPHX1may not be associated with EC development.展开更多
文摘Barrett’s esophagus is a well-known premalignant lesion of the lower esophagus that is characterized by intestinal metaplasia of the squamous epithelium. It is clinically important due to the increased risk (0.5% per annum) of progression to esophageal adenocarcinoma (EA), which has a poor outcome unless diagnosed early. The current clinical management of Barrett’s esophagus is hampered by the lack of accurate predictors of progression. In addition, when patients develop EA, the current staging modalities are limited in stratifying patients into different prognostic groups in order to guide the optimal therapy for an individual patient. Biomarkers have the potential to improve radically the clinical management of patients with Barrett’s esophagus and EA but have not yet entered mainstream clinical practice. This is in contrast to other cancers like breast and prostate for which biomarkers are utilized routinely to inform clinical decisions. This review aims to highlight the most promising predictive and prognostic biomarkers in Barrett’s esophagus and EA and to discuss what is required to move the field forward towards clinical application.
基金Supported by the Key Project of Clinical Medicine,Ministry of Health,No. 20012130
文摘AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated in rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence of esophagitis,Barrett's esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk (P < 0.01),being 96% and 100% (P > 0.05),88% and 82.4% (P > 0.05),20% and 52.1% (P < 0.05),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice.The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important prophylaxis for EAC.
文摘AIM:To summarize the relationship between p.Tyr113His and p.His139Arg polymorphisms in microsomal epoxide hydrolase(EPHX1)and risk for esophageal cancer(EC).METHODS:The MEDLINE/PubMed and EMBASE databases were searched for studies of the association between EPHX1 polymorphisms and EC risk that were published from the database inception date to April2013.A total of seven case-control studies,including seven on p.Tyr113His(cases,n=1118;controls,n=1823)and six on p.His139Arg(cases,n=861;controls,n=1571),were included in the meta-analysis.After data extraction by two investigators working independently,the meta-analyses were carried out with STATA 11.0 software.Pooled odds ratios and 95%CI were calculated using a fixed-effects model or a random-effects model,as appropriate.RESULTS:The pooled EPHX1 p.Tyr113His polymorphism data showed no significant association with EC in any of the genetic models(OR=1.00,95%CI:0.70-1.48 for Tyr/His vs Tyr/Tyr;OR=1.10,95%CI:0.77-1.57 for His/His vs Tyr/Tyr;OR=1.06,95%CI:0.75-1.49 for a dominant model;OR=1.09,95%CI:0.89-1.34 for a recessive model).Similar results were obtained from the p.His139Arg polymorphism analysis(Arg/His vs His/His:OR=1.02,95%CI:0.84-1.23;Arg/Arg vs His/His:OR=0.96,95%CI:0.60-1.54;OR=1.03,95%CI:0.78-1.37 for the dominant model;OR=0.97,95%CI:0.61-1.56 for the recessive model).Subgroup analyses for ethnicity,subtype of EC,and source of controls(population-based or hospital-based)showed trends that were consistent with the pooled analysis(reported above),with no significant associations found.CONCLUSION:This meta-analysis suggests that the p.Tyr113His and p.His139Arg polymorphisms in EPHX1may not be associated with EC development.
