巴雷特食道:一个回顾
1University of Kansas School of Medicine, VA Medical Center, Kansas City, Kansas.
JAMA
|August 16, 2022
概括
巴雷特食道,一种影响美国5%的疾病,增加食道腺癌的风险. 治疗包括酸性抑制和监测,并对形症或早期癌症进行内镜治疗.
科学领域:
- 胃肠道和瘤学
- 消化道疾病
- 转化和癌症的进展
背景情况:
- 巴雷特食道涉及食道状细胞的替换.
- 它影响美国5%和全球1%,食道腺癌的终身风险为3-5%.
- 风险因素包括年龄,男性性别,吸烟和胃食道反流症 (GERD).
研究的目的:
- 总结巴雷特食道的流行病学,风险因素和治疗方法.
- 突出从转化成腺癌的进展情况.
- 讨论当前的治疗和监测策略.
主要方法:
- 流行病学数据和临床观察的文献综述.
- 风险因素和流行率的分析.
- 目前管理指南和治疗结果的摘要.
主要成果:
- 巴雷特食道的患病率不同,老年男性和吸烟者的患病率更高.
- 每年发展为食道腺癌的比率为0.2%- 0.5%.
- 在80- 90%的患者中,内镜治疗有效治疗发育不良/ 早期癌症.
结论:
- 由于腺癌的风险,巴雷特食道需要保持警.
- 质子抑制剂可以治疗GERD,但它们的化学预防作用尚不确定.
- 建议进行内镜监测,但需要进行随机试验.
相关概念视频
Barrett Esophagus-I: Introduction
175
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
175
Barrett Esophagus-II: Clinical Manifestations and Management
284
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
284
Esophageal Strictures-II: Clinical Features and Management
152
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
152
Esophagus
1.3K
The esophagus, a muscular conduit linking the pharynx and stomach, measures roughly 10 inches (25.4 cm) and sits behind the trachea. It remains collapsed when not swallowing. The esophagus follows a predominantly straight path through the thoracic mediastinum and enters the abdominal cavity through a diaphragmatic opening known as the esophageal hiatus.
The movement of edibles from the pharynx into the esophagus is facilitated by the upper esophageal sphincter, which is formed primarily by the...
The movement of edibles from the pharynx into the esophagus is facilitated by the upper esophageal sphincter, which is formed primarily by the...
1.3K
Upper GI Series: Barium Swallow
804
The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
804
Esophageal Varices-II: Clinical Features and Management
124
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
124


