Recent advances in Barrett's esophagus

Ann N Y Acad Sci. 2018 Dec;1434(1):227-238. doi: 10.1111/nyas.13909. Epub 2018 Jul 5.

Abstract

Barrett's esophagus (BE) is the only known precursor of esophageal adenocarcinoma, one of the few cancers with increasing incidence in developed countries. The pathogenesis of BE is unclear with regard to either the cellular origin of this metaplastic epithelium or the manner in which malignant transformation occurs, although recent data indicate a possible junctional origin of stem cells for BE. Treatment of BE may be achieved using endoscopic eradication therapy; however, there is a lack of discriminatory tools to identify individuals at sufficient risk for cancer development in whom intervention is warranted. Reduction in gastroesophageal reflux of gastric contents including acid is mandatory to achieve remission from BE after endoscopic ablation, and can be achieved using medical or nonmedical interventions. Research topics of greatest interest include the mechanism of BE development and transformation to cancer, risk stratification methods to identify individuals who may benefit from ablation of BE, optimization of eradication therapy, and surveillance methods to ensure that remission is maintained after eradication is achieved.

Keywords: Barrett's esophagus; endoscopy; esophageal adenocarcinoma; imaging; screening; surveillance.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma* / metabolism
  • Adenocarcinoma* / pathology
  • Adenocarcinoma* / therapy
  • Barrett Esophagus* / metabolism
  • Barrett Esophagus* / pathology
  • Barrett Esophagus* / therapy
  • Esophageal Neoplasms* / metabolism
  • Esophageal Neoplasms* / pathology
  • Esophageal Neoplasms* / therapy
  • Gastroesophageal Reflux* / metabolism
  • Gastroesophageal Reflux* / pathology
  • Gastroesophageal Reflux* / therapy
  • Humans
  • Metaplasia
  • Neoplastic Stem Cells* / metabolism
  • Neoplastic Stem Cells* / pathology

Supplementary concepts

  • Adenocarcinoma Of Esophagus