PDF(Pubmed)
Abstract：
Barrett\'s oesophagus is the only known precursor to oesophageal adenocarcinoma, a cancer with very poor prognosis. The main risk factors for Barrett\'s oesophagus are a history of gastro-oesophageal acid reflux symptoms and obesity. Men, smokers and those with a family history are also at increased risk. Progression from Barrett\'s oesophagus to cancer occurs via an intermediate stage, known as dysplasia. However, dysplasia and early cancer usually develop without any clinical signs, often in individuals whose symptoms are well controlled by acid suppressant medications; therefore, endoscopic surveillance is recommended to allow for early diagnosis and timely clinical intervention. Individuals with Barrett\'s oesophagus need to be fully informed about the implications of this diagnosis and the benefits and risks of monitoring strategies. Pharmacological treatments are recommended for control of symptoms, but not for chemoprevention. Dysplasia and stage 1 oesophageal adenocarcinoma have excellent prognoses, since they can be cured with endoscopic or surgical therapies. Endoscopic resection is the most accurate staging technique for early Barrett\'s-related oesophageal adenocarcinoma. Endoscopic ablation is effective and indicated to eradicate Barrett\'s oesophagus in patients with dysplasia. Future research should focus on improved accuracy for dysplasia detection via new technologies and providing more robust evidence to support pathways for follow-up and treatment.
摘要：
Barrett食管是唯一已知的食管腺癌前兆,预后很差的癌症.Barrett食管的主要危险因素是胃食管酸反流和肥胖。男人,吸烟者和有家族史的人也有更高的风险。从Barrett的食道进展到癌症发生在中间阶段，被称为发育不良。然而,发育不良和早期癌症通常发展没有任何临床症状，通常在通过酸抑制剂药物很好地控制症状的个体中；因此，建议进行内镜监测,以便进行早期诊断和及时的临床干预.巴雷特食管患者需要充分了解这种诊断的意义以及监测策略的益处和风险。建议使用药物治疗来控制症状，但不是为了化学预防。异型增生和1期食管腺癌具有优异的预后，因为它们可以用内窥镜或手术疗法治愈。内镜切除是早期Barrett相关食管腺癌最准确的分期技术。内镜消融术是一种有效的治疗方法，可以根除Barrett食管的异型增生患者。未来的研究应该集中在通过新技术提高发育异常检测的准确性，并提供更有力的证据来支持后续和治疗的途径。
