Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC), an aggressive cancer with a poor prognosis. Our understanding of the pathogenesis and Barrett's metaplasia is incomplete, and this has limited the development of new therapeutic targets and agents, risk stratification ability, and management strategies. This review outlines current insights into the biology of BE and addresses controversies surrounding cell of origin, cellular reprogramming theories, updates on esophageal epithelial barrier function, and the significance of goblet cell metaplasia and its association with malignant change. Further research into the basic biology of BE is vital as it will underpin novel therapies and improve our ability to predict malignant progression and help identify the minority of patients who will develop EAC.

中文翻译：

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对巴雷特食管生物学的最新见解

巴雷特食管 (BE) 是唯一已知的食管腺癌 (EAC) 前兆，这是一种预后不良的侵袭性癌症。我们对发病机制和 Barrett 化生的理解不完整，这限制了新治疗靶点和药物的开发、风险分层能力和管理策略。本综述概述了目前对 BE 生物学的见解，并解决了围绕起源细胞、细胞重编程理论、食管上皮屏障功能的更新以及杯状细胞化生的重要性及其与恶性变化的关联的争议。对 BE 基础生物学的进一步研究至关重要，因为它将支持新疗法并提高我们预测恶性进展的能力，并有助于识别少数将发展为 EAC 的患者。