Barrett's esophagus: An update

Massimo Conio, Gabriella Lapertosa, Sabrina Blanchi, Rosangela Filiberti

Research output: Contribution to journalArticle

Abstract

Barrett's esophagus (BE) is a complication observed in a small subset of patients with chronic gastroesophageal reflux. It is characterized by the presence of intestinal-type goblet cells in biopsies from the lower esophagus. The prevalence of BE increases with age, affecting 1% of the population older than 60 years. A genetic predisposition to reflux disease has been proposed. In a twin study of reflux disease, concordance was greater in monozygotic than dizygotic twins. An association between BE and esophageal adenocarcinoma, the incidence of which has increased remarkably in the last few decades, has been established. Esophagogastric junction cancers can arise from small areas of cardia intestinal metaplasia (CIM). Regular endoscopic and histologic follow-up of BE patients is recommended. Surveillance of patients with CIM is not advised. Chromoendoscopy may help to detect areas of high-grade dysplasia (HGD). The ablation of BE, e.g. by PDT or argon plasma coagulation, is not yet proven to reduce the cancer risk. Esophagectomy is still the standard management of HGD. Endoscopic mucosal resection may be used for visible, localized lesions with HGD, and this technique may be combined with thermal ablation for areas of HGD without visible abnormality.

Original languageEnglish
Pages (from-to)187-206
Number of pages20
JournalCritical Reviews in Oncology/Hematology
Volume46
Issue number2
DOIs
Publication statusPublished - May 1 2003

Fingerprint

Barrett Esophagus
Cardia
Metaplasia
Argon Plasma Coagulation
Dizygotic Twins
Esophagogastric Junction
Twin Studies
Goblet Cells
Esophagectomy
Monozygotic Twins
Genetic Predisposition to Disease
Gastroesophageal Reflux
Esophagus
Neoplasms
Adenocarcinoma
Hot Temperature
Biopsy
Incidence
Population

Keywords

  • Barrett's esophagus
  • Cardia intestinal metaplasia
  • Chronic gastroesophageal reflux
  • High-grade dysplasia

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Barrett's esophagus : An update. / Conio, Massimo; Lapertosa, Gabriella; Blanchi, Sabrina; Filiberti, Rosangela.

In: Critical Reviews in Oncology/Hematology, Vol. 46, No. 2, 01.05.2003, p. 187-206.

Research output: Contribution to journalArticle

Conio, Massimo ; Lapertosa, Gabriella ; Blanchi, Sabrina ; Filiberti, Rosangela. / Barrett's esophagus : An update. In: Critical Reviews in Oncology/Hematology. 2003 ; Vol. 46, No. 2. pp. 187-206.
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