PDF(Pubmed)
Abstract：
Barrett\'s esophagus (BE) is a condition that results from replacement of the damaged normal squamous esophageal mucosa to intestinal columnar mucosa and is the most significant predisposing factor for development of esophageal adenocarcinoma. Current guidelines recommend endoscopic evaluation for screening and surveillance based on various risk factors which has limitations such as invasiveness, availability of a trained specialist, patient logistics and cost. Trans-nasal endoscopy is a less invasive modality but still has similar limitations such as limited availability of trained specialist and costs. Non-endoscopic modalities, in comparison, require minimal intervention, can be done in an office visit and has the potential to be a more ideal choice for mass public screening and surveillance, particularly in patents at low risk for BE. These include newer generations of esophageal capsule endoscopy which provides direct visualization of BE, and tethered capsule endomicroscopy which can obtain high-resolution images of the esophagus. Various cell collection devices coupled with biomarkers have been used for BE screening. Cytosponge, in combination with TFF3, as well as EsophaCap and EsoCheck have shown promising results in various studies when used with various biomarkers. Other modalities including circulatory microRNAs and volatile organic compounds that have demonstrated favorable outcomes. Use of these cell collection methods for BE surveillance is a potential area of future research.
摘要：
Barrett食管（BE）是由受损的正常食管鳞状粘膜替换为肠柱状粘膜引起的疾病，是食管腺癌发展的最重要的诱发因素。目前的指南建议基于各种风险因素进行内镜筛查和监测评估，这些因素具有局限性，例如侵入性，是否有训练有素的专家，患者后勤和成本。经鼻内窥镜检查是一种侵入性较小的方式，但仍具有类似的局限性，例如训练有素的专家的可用性和成本有限。非内窥镜模式，相比之下,需要最少的干预，可以在办公室访问中完成，并且有可能成为大众筛查和监视的更理想选择，特别是在低风险的专利中。这些包括新一代的食管胶囊内窥镜检查，可直接显示BE，和栓系胶囊显微内镜，可以获得高分辨率的食管图像。与生物标志物结合的各种细胞收集装置已用于BE筛选。细胞海绵,当与各种生物标志物一起使用时，与TFF3以及EsophaCap和EsoCheck的组合在各种研究中显示出有希望的结果。其他方式，包括循环microRNA和挥发性有机化合物，已显示出良好的结果。将这些细胞收集方法用于BE监测是未来研究的潜在领域。
