Barrett Esophagus
Barrett esophagus is a metaplastic change in the lining of the distal esophageal epithelium, characterized by replacement of the normal squamous epithelium by specialized intestinal metaplasia. The presence of Barrett esophagus increases the risk of esophageal adenocarcinoma several-fold. Esophageal...
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| Veröffentlicht in: | Mayo Clinic proceedings 2019-09, Vol.94 (9), p.1888-1901 |
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| creator | Iyer, Prasad G. Kaul, Vivek |
| description | Barrett esophagus is a metaplastic change in the lining of the distal esophageal epithelium, characterized by replacement of the normal squamous epithelium by specialized intestinal metaplasia. The presence of Barrett esophagus increases the risk of esophageal adenocarcinoma several-fold. Esophageal adenocarcinoma is a malignancy with rapidly rising incidence and persistently poor outcomes when diagnosed after the onset of symptoms. Risk factors for Barrett esophagus include chronic gastroesophageal reflux, central obesity, white race, male gender, older age, smoking, and a family history of Barrett esophagus or esophageal adenocarcinoma. Screening for Barrett esophagus in those with several risk factors followed by endoscopic surveillance to detect dysplasia or adenocarcinoma is currently recommended by society guidelines. Minimally invasive nonendoscopic tools for the early detection of Barrett esophagus are currently being developed. Multimodality endoscopic therapy—using a combination of endoscopic resection and ablation techniques—for the treatment of dysplasia and early adenocarcinoma is successful in eliminating intestinal metaplasia and preventing progression to adenocarcinoma, with outcomes comparable to those after esophagectomy. Risk stratification of those diagnosed with Barrett esophagus is a challenge at present, with active research focused on identifying clinical and biomarker panels to identify those with low and high risk of progression. This narrative review highlights some of the challenges and recent progress in this field. |
| doi_str_mv | 10.1016/j.mayocp.2019.01.032 |
| format | Article |
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The presence of Barrett esophagus increases the risk of esophageal adenocarcinoma several-fold. Esophageal adenocarcinoma is a malignancy with rapidly rising incidence and persistently poor outcomes when diagnosed after the onset of symptoms. Risk factors for Barrett esophagus include chronic gastroesophageal reflux, central obesity, white race, male gender, older age, smoking, and a family history of Barrett esophagus or esophageal adenocarcinoma. Screening for Barrett esophagus in those with several risk factors followed by endoscopic surveillance to detect dysplasia or adenocarcinoma is currently recommended by society guidelines. Minimally invasive nonendoscopic tools for the early detection of Barrett esophagus are currently being developed. Multimodality endoscopic therapy—using a combination of endoscopic resection and ablation techniques—for the treatment of dysplasia and early adenocarcinoma is successful in eliminating intestinal metaplasia and preventing progression to adenocarcinoma, with outcomes comparable to those after esophagectomy. Risk stratification of those diagnosed with Barrett esophagus is a challenge at present, with active research focused on identifying clinical and biomarker panels to identify those with low and high risk of progression. This narrative review highlights some of the challenges and recent progress in this field.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.1016/j.mayocp.2019.01.032</identifier><identifier>PMID: 31486383</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adenocarcinoma ; Aged ; Barrett esophagus ; Barrett Esophagus - diagnosis ; Barrett Esophagus - epidemiology ; Barrett Esophagus - pathology ; Barrett Esophagus - surgery ; Biopsy ; Biopsy, Needle ; Cell Transformation, Neoplastic - pathology ; Cryotherapy ; Diagnosis ; Dysplasia ; Early Detection of Cancer - methods ; Endoscopy ; Endoscopy - methods ; Epithelium ; Esophageal cancer ; Esophagoscopy - methods ; Esophagus ; Female ; Gastroenterology ; Gastroesophageal reflux ; Health risk assessment ; Humans ; Immunohistochemistry ; Incidence ; Invasiveness ; Male ; Methylene blue ; Middle Aged ; Mortality ; Mucosa ; Nitrogen ; Obesity ; Patients ; Population ; Precancerous Conditions - pathology ; Prognosis ; Quality of life ; Risk Assessment ; Risk factors ; Surveillance ; Systematic review ; Treatment Outcome</subject><ispartof>Mayo Clinic proceedings, 2019-09, Vol.94 (9), p.1888-1901</ispartof><rights>2019 Mayo Foundation for Medical Education and Research</rights><rights>Copyright © 2019 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.</rights><rights>COPYRIGHT 2019 Frontline Medical Communications Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research Sep 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-2dc1985d936af87594d1fb2262a8db8409d7b2afd2663614ab33f3fe4c358c353</citedby><cites>FETCH-LOGICAL-c473t-2dc1985d936af87594d1fb2262a8db8409d7b2afd2663614ab33f3fe4c358c353</cites><orcidid>0000-0002-9822-1420</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31486383$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iyer, Prasad G.</creatorcontrib><creatorcontrib>Kaul, Vivek</creatorcontrib><title>Barrett Esophagus</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>Barrett esophagus is a metaplastic change in the lining of the distal esophageal epithelium, characterized by replacement of the normal squamous epithelium by specialized intestinal metaplasia. The presence of Barrett esophagus increases the risk of esophageal adenocarcinoma several-fold. Esophageal adenocarcinoma is a malignancy with rapidly rising incidence and persistently poor outcomes when diagnosed after the onset of symptoms. Risk factors for Barrett esophagus include chronic gastroesophageal reflux, central obesity, white race, male gender, older age, smoking, and a family history of Barrett esophagus or esophageal adenocarcinoma. Screening for Barrett esophagus in those with several risk factors followed by endoscopic surveillance to detect dysplasia or adenocarcinoma is currently recommended by society guidelines. Minimally invasive nonendoscopic tools for the early detection of Barrett esophagus are currently being developed. Multimodality endoscopic therapy—using a combination of endoscopic resection and ablation techniques—for the treatment of dysplasia and early adenocarcinoma is successful in eliminating intestinal metaplasia and preventing progression to adenocarcinoma, with outcomes comparable to those after esophagectomy. Risk stratification of those diagnosed with Barrett esophagus is a challenge at present, with active research focused on identifying clinical and biomarker panels to identify those with low and high risk of progression. This narrative review highlights some of the challenges and recent progress in this field.</description><subject>Adenocarcinoma</subject><subject>Aged</subject><subject>Barrett esophagus</subject><subject>Barrett Esophagus - diagnosis</subject><subject>Barrett Esophagus - epidemiology</subject><subject>Barrett Esophagus - pathology</subject><subject>Barrett Esophagus - surgery</subject><subject>Biopsy</subject><subject>Biopsy, Needle</subject><subject>Cell Transformation, Neoplastic - pathology</subject><subject>Cryotherapy</subject><subject>Diagnosis</subject><subject>Dysplasia</subject><subject>Early Detection of Cancer - methods</subject><subject>Endoscopy</subject><subject>Endoscopy - methods</subject><subject>Epithelium</subject><subject>Esophageal cancer</subject><subject>Esophagoscopy - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroesophageal reflux</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Incidence</subject><subject>Invasiveness</subject><subject>Male</subject><subject>Methylene blue</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Mucosa</subject><subject>Nitrogen</subject><subject>Obesity</subject><subject>Patients</subject><subject>Population</subject><subject>Precancerous Conditions - pathology</subject><subject>Prognosis</subject><subject>Quality of life</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Surveillance</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><issn>0025-6196</issn><issn>1942-5546</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kEtLAzEURoMotj4W7kUEwd2MeXeyEWqpDyi40XXI5NGmtJOazAj996ZMFd1IuATC-e7NPQBcIlgiiPjdslyrbdCbEkMkSohKSPABGCJBccEY5YdgCCFmBUeCD8BJSksI4UgIegwGBNGKk4oMwcWDitG27fU0hc1Czbt0Bo6cWiV7vr9Pwfvj9G3yXMxen14m41mh6Yi0BTYaiYoZQbhy1YgJapCrMeZYVaauKBRmVGPlDOaccERVTYgjzlJNWJWLnIKbvu8mho_OplYuQxebPFJiXFHBCGQ8U2VPzdXKSt-40Eal8zF27XVorPP5fcwhQyQvtGt7-yuwsGrVLlJYda0PTfoL0h7UMaQUrZOb6NcqbiWCcmdYLmVvWO4MS4hkNpxjV_tvd_Xamp_Qt9IM3PeAzfI-vY0yaW8bbY2PVrfSBP__hC-Idoox</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Iyer, Prasad G.</creator><creator>Kaul, Vivek</creator><general>Elsevier Inc</general><general>Frontline Medical Communications Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4U-</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><orcidid>https://orcid.org/0000-0002-9822-1420</orcidid></search><sort><creationdate>201909</creationdate><title>Barrett Esophagus</title><author>Iyer, Prasad G. ; Kaul, Vivek</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-2dc1985d936af87594d1fb2262a8db8409d7b2afd2663614ab33f3fe4c358c353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adenocarcinoma</topic><topic>Aged</topic><topic>Barrett esophagus</topic><topic>Barrett Esophagus - diagnosis</topic><topic>Barrett Esophagus - epidemiology</topic><topic>Barrett Esophagus - pathology</topic><topic>Barrett Esophagus - surgery</topic><topic>Biopsy</topic><topic>Biopsy, Needle</topic><topic>Cell Transformation, Neoplastic - pathology</topic><topic>Cryotherapy</topic><topic>Diagnosis</topic><topic>Dysplasia</topic><topic>Early Detection of Cancer - methods</topic><topic>Endoscopy</topic><topic>Endoscopy - methods</topic><topic>Epithelium</topic><topic>Esophageal cancer</topic><topic>Esophagoscopy - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroesophageal reflux</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Incidence</topic><topic>Invasiveness</topic><topic>Male</topic><topic>Methylene blue</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Mucosa</topic><topic>Nitrogen</topic><topic>Obesity</topic><topic>Patients</topic><topic>Population</topic><topic>Precancerous Conditions - pathology</topic><topic>Prognosis</topic><topic>Quality of life</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Surveillance</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iyer, Prasad G.</creatorcontrib><creatorcontrib>Kaul, Vivek</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iyer, Prasad G.</au><au>Kaul, Vivek</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Barrett Esophagus</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2019-09</date><risdate>2019</risdate><volume>94</volume><issue>9</issue><spage>1888</spage><epage>1901</epage><pages>1888-1901</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><abstract>Barrett esophagus is a metaplastic change in the lining of the distal esophageal epithelium, characterized by replacement of the normal squamous epithelium by specialized intestinal metaplasia. The presence of Barrett esophagus increases the risk of esophageal adenocarcinoma several-fold. Esophageal adenocarcinoma is a malignancy with rapidly rising incidence and persistently poor outcomes when diagnosed after the onset of symptoms. Risk factors for Barrett esophagus include chronic gastroesophageal reflux, central obesity, white race, male gender, older age, smoking, and a family history of Barrett esophagus or esophageal adenocarcinoma. Screening for Barrett esophagus in those with several risk factors followed by endoscopic surveillance to detect dysplasia or adenocarcinoma is currently recommended by society guidelines. Minimally invasive nonendoscopic tools for the early detection of Barrett esophagus are currently being developed. Multimodality endoscopic therapy—using a combination of endoscopic resection and ablation techniques—for the treatment of dysplasia and early adenocarcinoma is successful in eliminating intestinal metaplasia and preventing progression to adenocarcinoma, with outcomes comparable to those after esophagectomy. Risk stratification of those diagnosed with Barrett esophagus is a challenge at present, with active research focused on identifying clinical and biomarker panels to identify those with low and high risk of progression. This narrative review highlights some of the challenges and recent progress in this field.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>31486383</pmid><doi>10.1016/j.mayocp.2019.01.032</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-9822-1420</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adenocarcinoma Aged Barrett esophagus Barrett Esophagus - diagnosis Barrett Esophagus - epidemiology Barrett Esophagus - pathology Barrett Esophagus - surgery Biopsy Biopsy, Needle Cell Transformation, Neoplastic - pathology Cryotherapy Diagnosis Dysplasia Early Detection of Cancer - methods Endoscopy Endoscopy - methods Epithelium Esophageal cancer Esophagoscopy - methods Esophagus Female Gastroenterology Gastroesophageal reflux Health risk assessment Humans Immunohistochemistry Incidence Invasiveness Male Methylene blue Middle Aged Mortality Mucosa Nitrogen Obesity Patients Population Precancerous Conditions - pathology Prognosis Quality of life Risk Assessment Risk factors Surveillance Systematic review Treatment Outcome |
| title | Barrett Esophagus |
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