Innovative endoscopic mapping technique of Barrett's mucosa

Barrett's esophagus is the most common premalignant lesion of the upper gastrointestinal tract. This metaplastic change in the normal esophageal epithelium occurs in 10% to 15% of patients with chronic reflux esophagitis and is associated with a 30- to 40-fold increased risk of developing esophageal cancer. Cancers of the esophagus and gastroesophageal junction are increasing in incidence faster than any other cancer in the Western world. Despite the importance of this cancer epidemic and its well-known precursor lesion, most investigators have taken a subjective approach to quantifying the extent of disease, the location of abnormal tissues, and the effect of ablation techniques. Our ability to impact on this epidemic may be dependent on our ability to apply modern technologies to document quantitatively both the extent of disease and the severity of molecular derangement of the intrinsic growth regulatory mechanism of the metaplastic cells. This review will focus on the challenge of addressing the quantitative endoscopic findings in Barrett's esophagus.