Partial regression of Barrett's esophagus--an inadequate endpoint.
A patient with Barrett's esophagus and high grade dysplasia is presented. He underwent a fundoplication and, subsequently, nearly three years of high-dose proton pump inhibition therapy. At the time of esophagogastrectomy, extensive squamous re-epithelialization was observed along with two histologic foci of intramucosal adenocarcinoma. Despite partial regression of Barrett's esophagus, high grade dysplasia present for more than 4 years had progressed to adenocarcinoma. Partial squamous repopulation of Barrett's esophagus is an inadequate endpoint of therapy. Complete regression is necessary to eliminate the risk of cancer.
Sampliner
R E
RE
Department of Medicine, University of Arizona Health Sciences Center, Tucson.
Fass
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D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology; D001471:Barrett Esophagus / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged