[Barrett esophagus--a premalignant disorder requiring a program of endoscopic follow-up?].
Barrett's esophagus is a premalignant disorder in which the stratified squamous epithelium is replaced by metaplastic epithelium. The pathogenesis of Barrett's esophagus is not yet well understood, but it is almost certainly a multistep process with both genetic and environmental predispositions. Barrett's metaplasia is generally believed to be an intermediate step in the development of esophageal adenocarcinoma. In Barrett's esophagus a variety of molecular genetic changes has been correlated with the metaplasia-dysplasia-carcinoma sequence. Diagnosis is made by endoscopic visualization and confirmed by biopsy results. The main goals of medical therapy for the patients with Barrett's esophagus are similar for the patients with gastroesophageal reflux disease, that is to control symptoms of reflux and to heal inflamed esophageal mucosa, obtained by using acid-suppressive therapy with proton pump inhibitors. The aim of endoscopic surveillance of patients with BE is to assess the risk of development of carcinoma, to detect dysplasia and early-stage, potentially curable cancer. An innovative and alternative approach to treatment is the use of mucosal ablative techniques in an attempt to destroy the metaplastic epithelium.
Cuković-Cavka
Silvija
S
Zavod za gastroenterologiju Klinike za unutrasnje bolesti KBC Rebro, Zagreb.
D000230:Adenocarcinoma / Q000209:etiology; D001471:Barrett Esophagus / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000209:etiology; D004945:Esophagoscopy; D006801:Humans; D008875:Middle Aged; D011230:Precancerous Conditions / Q000150:complications / Q000175:diagnosis* / Q000473:pathology