title: Detection and endoscopic therapy of early esophageal adenocarcinoma.
abstract: OBJECTIVE
  This review summarizes recent progress on endoscopic diagnosis and treatment of esophageal high-grade intraepithelial neoplasia and early adenocarcinoma and critically analyzes the literature in the context of preexisting scientific data.
  
  
  RESULTS
  Narrow band imaging and computed virtual chromoendoscopy enhanced visualization of the mucosal morphology. The type of mucosal and capillary patterns seen on narrow band imaging predicted the presence of specialized intestinal metaplasia, high-grade intraepithelial neoplasia and early adenocarcinoma. Endocytoscopy lacked sufficient image quality for clinical use currently. Optical coherence tomography had the potential to diagnose specialized intestinal metaplasia and dysplasia. Photodynamic therapy produced long-term ablation of high-grade intraepithelial neoplasia and reduced cancer risk. Endoscopic radiofrequency ablation of Barrett's mucosa did not cause strictures and buried glandular mucosa. Localized and radical or complete circumferential endoscopic mucosal resections were effective and safe.
  
  
  CONCLUSIONS
  Virtual chromoendoscopy detected subtle mucosal lesions and facilitated targeted biopsies. Photodynamic therapy was effective in the long term. Endoscopic radiofrequency ablation appeared promising. Localized and radical or complete circumferential endoscopic mucosa resections were effective therapies.
authors.affiliation: Department of Interdisciplinary Endoscopy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. seewald@uke.uni-hamburg.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Seewald
authors.forename: Tiing Leong
authors.initials: TL
authors.lastname: Ang
authors.forename: Stefan
authors.initials: S
authors.lastname: Groth
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhong
authors.forename: Philipp
authors.initials: P
authors.lastname: Bertschinger
authors.forename: Josef
authors.initials: J
authors.lastname: Altorfer
authors.forename: Frank
authors.initials: F
authors.lastname: Thonke
authors.forename: Nib
authors.initials: N
authors.lastname: Soehendra
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy*; D017115:Catheter Ablation; D004724:Endoscopy / Q000379:methods; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D016629:Esophagectomy; D006801:Humans; D010778:Photochemotherapy; D041623:Tomography, Optical Coherence