Barrett's oesophagus: Frequency and prediction of dysplasia and cancer

Falk, Gary W.

doi:10.1016/j.bpg.2015.01.001

Cited by 11 publications

(9 citation statements)

References 115 publications

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“…However, the natural history of BE is incompletely understood. Overall, the incidence of progression from metaplasia to high-grade dysplasia (HGD) or EAC is approximately 0.26–0.63 % per year [ 6 ], and that to EAC alone 0.12 % [ 7 ]. However, only a minority of patients progress to low-grade dysplasia (LGD), and of those that do similarly only a minority ultimately progress to HGD or EAC [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Genetic Biomarkers of Barrett’s Esophagus Susceptibility and Progression to Dysplasia and Cancer: A Systematic Review and Meta-Analysis

2015

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Barrett’s esophagus (BE) is a common and important precursor lesion of esophageal adenocarcinoma (EAC). A third of patients with BE are asymptomatic, and our ability to predict the risk of progression of metaplasia to dysplasia and EAC (and therefore guide management) is limited. There is an urgent need for clinically useful biomarkers of susceptibility to both BE and risk of subsequent progression. This study aims to systematically identify, review, and meta-analyze genetic biomarkers reported to predict both. A systematic review of the PubMed and EMBASE databases was performed in May 2014. Study and evidence quality were appraised using the revised American Society of Clinical Oncology guidelines, and modified Recommendations for Tumor Marker Scores. Meta-analysis was performed for all markers assessed by more than one study. A total of 251 full-text articles were reviewed; 52 were included. A total of 33 germline markers of susceptibility were identified (level of evidence II–III); 17 were included. Five somatic markers of progression were identified; meta-analysis demonstrated significant associations for chromosomal instability (level of evidence II). One somatic marker of progression/relapse following photodynamic therapy was identified. However, a number of failings of methodology and reporting were identified. This is the first systematic review and meta-analysis to evaluate genetic biomarkers of BE susceptibility and risk of progression. While a number of limitations of study quality temper the utility of those markers identified, some—in particular, those identified by genome-wide association studies, and chromosomal instability for progression—appear plausible, although robust validation is required.Electronic supplementary materialThe online version of this article (doi:10.1007/s10620-015-3884-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Genetic Biomarkers of Barrett’s Esophagus Susceptibility and Progression to Dysplasia and Cancer: A Systematic Review and Meta-Analysis

2015

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“…The incidence of EAC is increasing and due to late carcinoma detection the 5-year survival rate is low (less than 20 %) (17,18). As well as BE as a complication of gastroesophageal reflux disease, there are other well known risk factors for EAC such as male gender, smoking and obesity (19)(20)(21).…”

Section: A B Cmentioning

confidence: 99%

“…The length of BE segment is also assessed as a risk factor for EAC progression. The risk of progression increased from 19 % to 28 % for every 1 cm increase in the length of the BE (19,24,25). Richardson et al (26) in 2018 in his work showed that multiple real -time pCLE can evaluate the entire segment of the BE.…”

Section: A B Cmentioning

confidence: 99%

Confocal laser endomicroscopy in the diagnostics of esophageal diseases: a pilot study

Kunovský¹,

Kala²,

Kroupa³

et al. 2020

Vnitř Lék

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Background: Probe -based confocal laser endomicroscopy (pCLE) is a novel diagnostic technique for endoscopy which enables a microscopic view at a cellular resolution in real -time. Endoscopic detection of early neoplasia in the distal esophagus is difficult and often these lesions can be missed. The aim of the pilot study was to obtain characteristic pCLE figures in esophageal diseases for following studies, and to evaluate the possible future role of pCLE in the diagnostics of dysplastic Barrett's esophagus (BE) or early esophageal adenocarcinoma (EAC). Methods: A review of the current literature was performed and previously published pCLE images and classifications of esophageal diseases were searched and studied first. In phase two of the pilot study patients with esophageal diseases such as reflux esophagitis, BE and EAC were enrolled and scheduled for upper endoscopy with pCLE. A healthy cohort was also included. Results: From January 2019 to July 2019, a total of 14 patients were enrolled in this prospective pilot study: 3 patients with reflux esophagitis, 4 with BE, 3 with EAC and 4 persons were included in the healthy cohort. The endoscopy with pCLE was performed and characteristic pCLE figures were obtained. The correct diagnoses based on real -time pCLE were evaluated by an endoscopist in 11 of the 14 cases (78.6 %). Conclusion: It was possible to obtain typical pCLE images of esophageal diseases during a standard cap -assisted endoscopic procedure. pCLE seems to be a feasible new technique in BE surveillance and early neoplastic lesion detection. However, more studies and data on larger number of patients are needed.

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“…Obesity, in particular a body mass index of >30 is associated with an approximate 2-fold increased risk for EAC (17). Strong epidemiologic risk factors include aging, male gender, obesity and smoking (18). The regional differences observed in the incidence of EAC indicate that race is a strong risk factor for EAC.…”

Section: Epidemiologymentioning

confidence: 99%

“…The maximum stand uptake value (SUVmax) together with the tumor/normal esophageal ratio could be used to evaluate the effect of neoadjuvant chemotherapy (82). Additionally, [(18)F] fluorodeoxyglucose (FDG)-PET positive lymph node analysis can be used to predict survival of patients who underwent neoadjuvant chemotherapy (83). Additional factors predicting outcome of neoadjuvant therapy can be found in a recent review by Tao et al (84).…”

Section: Treatmentmentioning

confidence: 99%

Esophageal cancer: The latest on chemoprevention and state of the art therapies

Bras

Farooq

Falk

et al. 2016

Pharmacological Research

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Esophageal cancer is currently the 8th most common cancer worldwide and the 6th leading cause of cancer-related mortality. Despite remarkable advances, the mortality for those suffering from esophageal cancer remains high, with 5-year survival rates of less than 20%. In part, because most patients present with late-stage disease, long-term survival even after resection and therapy is disappointingly low. As we will discuss in this review, multiple characteristics specific to the disease stage and patient must be considered when choosing a treatment plan. This article will summarize current standard therapies, potential application of chemoprevention drugs and the promise and partial failure of personalized medicine, as well as novel treatments addressing this disease.

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Barrett's oesophagus: Frequency and prediction of dysplasia and cancer

Cited by 11 publications

References 115 publications

Genetic Biomarkers of Barrett’s Esophagus Susceptibility and Progression to Dysplasia and Cancer: A Systematic Review and Meta-Analysis

Genetic Biomarkers of Barrett’s Esophagus Susceptibility and Progression to Dysplasia and Cancer: A Systematic Review and Meta-Analysis

Confocal laser endomicroscopy in the diagnostics of esophageal diseases: a pilot study

Esophageal cancer: The latest on chemoprevention and state of the art therapies

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