[Barrett esophagus with severe dysplasia in argon beam therapy].
A curative therapy of Barrett's esophagus is not established, yet. However, in prospective clinical research trials, a combined therapy of potent pharmacological acid suppression with superficial coagulation of metaplastic epithelium is examined. By local coagulation using photodynamic therapy, laser or argon plasma coagulation, a complete reconstitution of squamous epithelium should be achieved. We report on a case of a patient with Barrett's esophagus and low-grade dysplasia, who developed high-grade dysplastic cell formations under argon plasma coagulation therapy. As part of a clinical study, the patient was treated over a period of one year monthly. We monitored the result of the therapy over the period of one year with endoscopy, histolgical investigations and DNA image cytometry. Ultimately a decision in favour of a further surgical management was made. The diagnostic instruments to identify patients with a high risk for the development of adenocarcinoma are discussed.
Maass
S
S
Medizinische Klinik C, Klinikums Ludwigshafen gGmbH.
Martin
W R
WR
Spiethoff
A
A
Riemann
J F
JF
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000782:Aneuploidy; D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000032:analysis; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D004947:Esophagus / Q000473:pathology; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*
D004273:DNA, Neoplasm
Barrett-Osophagus mit schweren Dysplasien unter Argon-Beamer-Therapie.