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Barrett oesophagus.
Nature Reviews Disease Primers ( IF 81.5 ) Pub Date : 2019-05-23 , DOI: 10.1038/s41572-019-0086-z
Yonne Peters 1 , Ali Al-Kaabi 1 , Nicholas J Shaheen 2 , Amitabh Chak 3 , Andrew Blum 3 , Rhonda F Souza 4 , Massimiliano Di Pietro 5 , Prasad G Iyer 6 , Oliver Pech 7 , Rebecca C Fitzgerald 5 , Peter D Siersema 1
Affiliation  

Barrett oesophagus (BE), the only known histological precursor of oesophageal adenocarcinoma (EAC), is a condition in which the squamous epithelium of the oesophagus is replaced by columnar epithelium as an adaptive response to gastro-oesophageal reflux. EAC has one of the fastest rising incidences of cancers in Western countries and has a dismal prognosis. BE is usually detected during endoscopic examination, and diagnosis is confirmed by the histological presence of intestinal metaplasia. Advances in genomics and transcriptomics have improved our understanding of the pathogenesis and malignant progression of intestinal metaplasia. As the majority of EAC cases are diagnosed in individuals without a known history of BE, screening for BE could potentially decrease disease-related mortality. Owing to the pre-malignant nature of BE, endoscopic surveillance of patients with BE is imperative for early detection and treatment of dysplasia to prevent further progression to invasive EAC. Developments in endoscopic therapy have resulted in a major shift in the treatment of patients with BE who have dysplasia or early EAC, from surgical resection to endoscopic resection and ablation. In addition to symptom control by optimization of lifestyle and pharmacological therapy with proton pump inhibitors, chemopreventive strategies based on NSAIDs and statins are currently being investigated for BE management.

中文翻译:

巴雷特食管。

Barrett食道(BE)是食道腺癌(EAC)唯一已知的组织学前体,是一种食道鳞状上皮被柱状上皮代替,作为对胃食管反流的适应性反应的疾病。EAC是西方国家癌症发病率上升最快的疾病之一,预后令人沮丧。通常在内窥镜检查期间检测到BE,并且通过肠上皮化生的组织学存在来证实诊断。基因组学和转录组学的进展提高了我们对肠化生的发病机理和恶性进展的认识。由于大多数EAC病例是在没有已知BE病史的个人中诊断出来的,因此筛查BE可能会降低与疾病相关的死亡率。由于BE的恶性性质,必须对BE患者进行内窥镜监测,以及早发现和治疗不典型增生,以防止进一步发展为侵入性EAC。内镜治疗的发展已导致患有发育异常或早期EAC的BE患者的治疗方式发生了重大变化,从手术切除到内窥镜切除和消融。除了通过优化生活方式和使用质子泵抑制剂进行药物治疗来控制症状外,目前还正在研究基于NSAID和他汀类药物的化学预防策略以进行BE管理。从手术切除到内窥镜切除和消融。除了通过优化生活方式和使用质子泵抑制剂进行药物治疗来控制症状外,目前还正在研究基于NSAID和他汀类药物的化学预防策略以进行BE管理。从手术切除到内窥镜切除和消融。除了通过优化生活方式和使用质子泵抑制剂进行药物治疗来控制症状外,目前还正在研究基于NSAID和他汀类药物的化学预防策略以进行BE管理。
更新日期:2019-11-18
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