Abstract:
Esophageal adenocarcinoma (EAC) is rapidly increasing in incidence and is associated with a poor prognosis. Barrett\'s esophagus (BE) is a known precursor of esophageal adenocarcinoma. This review aims to explore Barrett\'s esophagus, esophageal adenocarcinoma, and the progression from the former to the latter. An overview of the definition, diagnosis, epidemiology, and risk factors for both entities are presented, with special attention being given to the areas of debate in the literature. The progression from Barrett\'s esophagus to esophageal adenocarcinoma is reviewed and the relevant molecular pathways are discussed. The definition of Barrett\'s esophagus remains debated and without international consensus. This, alongside other factors, has made establishing the true prevalence of Barrett\'s esophagus challenging. The degree of dysplasia can be a histological challenge, but is necessary to guide clinical management. The progression of BE to EAC is likely driven by inflammatory pathways, pepsin exposure, upregulation of growth factor pathways, and mitochondrial changes. Surveillance is maintained through serial endoscopic evaluation, with shorter intervals recommended for high-risk features.
摘要:
食管腺癌(EAC)的发病率迅速增加,并与预后不良有关。Barrett食管(BE)是已知的食管腺癌的前体。这篇综述旨在探讨巴雷特食管,食管腺癌,以及从前者到后者的发展。定义的概述,诊断,流行病学,并列出了两个实体的风险因素,特别关注文献中的辩论领域。本文综述了Barrett食管向食管腺癌的进展,并讨论了相关的分子通路。巴雷特食管的定义仍存在争议,没有国际共识。这个,除了其他因素,建立巴雷特食管的真正患病率具有挑战性。发育不良的程度可能是一个组织学挑战,但指导临床管理是必要的。BE向EAC的进展可能是由炎症途径驱动的,胃蛋白酶暴露,生长因子途径的上调,和线粒体变化。通过连续的内窥镜评估来维持监测,较短的间隔建议高风险的特征。