[巴雷特食道:关于诊断和治疗的最新情况. [审查] 审查] 审查
Alberto Espino1, José Ignacio Vargas1, Gonzalo Latorre1
1Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.
概括
巴雷特食道 (Barrett's esophagus,BE) 是食道腺癌 (EAC) 的前体,需要诊断出肠道代谢. 管理包括生活方式的改变,PPI,监测,和内镜治疗失育症或早期癌症.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 巴雷特食道 (Barrett's esophagus,简称BE) 涉及到代塑性柱状粘膜,取代了食道中的状粘膜.
- BE影响1%的普通人口和高达14%的GERD患者,增加食道腺癌 (EAC) 的风险.
- 在BE中,EAC的危险因素包括男性性别,年龄大于50岁,肥胖和吸烟.
研究的目的:
- 概述巴雷特食道的诊断,风险因素和管理.
- 详细介绍从BE发展为食道腺癌的进展情况以及相关风险.
- 描述当前治疗非发育不良的BE和带有发育不良或早期癌症的BE的治疗策略.
主要方法:
- 诊断需要与杯细胞 (≥1厘米) 的肠道代谢 (IM).
- 根据发育不良等级的风险分层:非发育不良的BE (0.1-0.3%的EAC风险),低度发育不良 (LGD) (0.5%的EAC风险),高度发育不良 (HGD) (5-8%的EAC风险).
- 监测内镜每3-5年进行一次,以检查非发育不良的BE.
主要成果:
- 每年的EAC风险因发育不良而异:0.1-0.3% (没有),0.5% (LGD),5-8% (HGD).
- 非发育不良的BE管理:生活方式的改变,PPI,监测.
- 用内镜治疗肌肉发育不良/早期癌症的肌肉发育不良,成功率为~90%,主要不良事件是狭窄.
结论:
- 巴雷特食道是食道腺癌的重要前体.
- 及时诊断和风险分层对于有效管理至关重要.
- 内镜治疗在BE患者的发育不良和早期癌症中具有很高的成功率.
相关概念视频
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