Barrett's Esophagus

Abstract

The last 2 decades have seen dramatic advances in Barrett's esophagus. The definition has evolved; the rising incidence of adenocarcinoma has been recognized; and effective therapy to control gastroesophageal reflux disease has been developed. Both proton pump inhibitor therapy and laparoscopic fundoplication represent major developments. Studies of patients with dysplasia have helped to clarify appropriate surveillance intervals and treatment strategies for these patients, although controversy still exists. The possibility of reversing Barrett's esophagus in selected high-risk patients offers major hope for the future prevention of adenocarcinoma of the esophagus.

Deletion at Fragile Sites Is a Common and Early Event in Barrett's Esophagus

“…Barrett’s esophagus is therefore of considerable clinical significance since the five-year survival rate of esophageal adenocarcinoma is only ~10%, unless detected at an early stage, in which case it is curable. It is therefore recommended that BE patients be managed by endoscopic surveillance; however, at present 95% of patients with esophageal adenocarcinoma do not have a prior diagnosis of Barrett’s esophagus (4). It is therefore important to define biomarkers which could be readily applied to patients with GERD to identify those who have BE and are at risk for EA, and would therefore benefit from endoscopic surveillance and/or medical or surgical intervention.…”