Trattamento endoscopico del Barrett associato a displasia e a k intramucoso

Endoscopic eradication therapy for patients with Barrett's esophagus-associated dysplasia and intramucosal cancer.Standards of Practice Committee, Wani S, Qumseya B, Sultan S, Agrawal D, Chandrasekhara V, Harnke B, Kothari S, McCarter M, Shaukat A, Wang A, Yang J, Dewitt J. Gastrointest Endosc. 2018 Apr;87(4):907-931.e9. doi: 10.1016/j.gie.2017.10.011. Epub 2018 Feb 15.

 

Barrett’s esophagus (BE) is defined by the replacement of the normal squamous epithelium of the distal esophagus with metaplastic intestinal-type columnar epithelium.

1, 2, 3 BE is an adverse event of chronic GERD and the only identifiable premalignant condition for esophageal adenocarcinoma (EAC), a cancer that continues to increase in incidence. In 2014 there were approximately 18,170 incident cases of esophageal cancer in the United States, nearly 60% of which were EAC.4, 5, 6 Although uncommon, EAC is a highly lethal cancer associated with a poor 5-year survival rate of 15% to 20% and an overall median survival of <1 year in cases with advanced disease.5, 6, 7 It is estimated that BE is present in 1% to 2% of the general adult population.8, 9 The stepwise and hypothesized progression of BE to invasive EAC is believed to occur through the histopathologic stages of intestinal metaplasia to low-grade dysplasia (LGD) to high-grade dysplasia (HGD) to intramucosal EAC and finally to invasive EAC.3, 10, 11, 12

 

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