Barrett’s Esophagus in 2012: Updates in Pathogenesis, Treatment, and Surveillance

Abstract

Barrett’s esophagus (BE) is the only established precursor lesion in the development of esophageal adenocarcinoma (EAC) and increases the risk of cancer by eleven fold. It is regarded as a complication of gastroesophageal reflux disease. There is ever increasing body of knowledge on the pathogenesis, diagnosis, treatment and surveillance of BE and its associated dysplasia. In this review, we summarize the latest advances in BE research and clinical practice in the past 2 years. It is critical to understand both the molecular underpinnings of this disorder to comprehend the clinical outcomes of the disease. For clinical gastroenterologists, there is also continuous growth of endoscopic approaches is daunting and further improvements in the detection and treatment of BE and early EAC are anticipated. In the future, we may see the increased role of biomarkers, both molecular and imaging, in both diagnostic and therapeutic strategies for BE.

Screening and Preventive Strategies in Esophagogastric Cancer

“…Nodular lesions in dysplastic BE can be resected through either endoscopic mucosal resection or endoscopic submucosal dissection. 75 Pech and colleagues 76 compared endoscopic resection to esophagectomy in a multicenter retrospective cohort study and found complete remission in 98.7% of subjects treated with endoscopic resection. Few subjects undergoing endoscopic resection had complications, whereas 32% had major complications after esophagectomy.…”

Overview of genetic and epigenetic alterations in the pathogenesis of esophagogastric junctional adenocarcinoma and esophageal adenocarcinoma: recent findings by next generation sequencing

“…[6] Epidemiological studies have revealed that adenocarcinomas occur from BE through multistep morphological changes, such as low-grade to high-grade dysplasia. [6,7] BE and EGJ adenocarcinoma/ EAC share poly-genetic/epigenetic alterations. [8] BE can be described as mucosal replacement of normal squamous epithelium with metaplastic columnar mucosa, known as specialized columnar metaplasia, in response to chronic gastroesophageal refl ux disease (GERD).…”

Successful resection of esophageal carcinosarcoma in presence of right aortic arch: a case report

“…It comprises approximately 0.36%-2.8% of all esophageal malignancies. [1,2] According to a literature search using PubMed, most reported cases were smaller than 17 cm in length, while a tumor occupying the entire esophagus was quite less frequently seen. [3] Right aortic arch (RAA) is an intrathoracic great vessel anomaly that has been reported to be present in 0.04%-0.1% of autopsy cases.…”