最近在巴雷特食道患者的风险分层方面取得的进展
Varan Perananthan1, Prasad G Iyer2
1Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA.
概括
巴雷特食道 (BE) 癌症的风险大大不同. 结合临床,分子和成像数据的新方法旨在实现个性化的监测,以改善早期检测并减少过度治疗.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 巴雷特食道 (BE) 是食道腺癌的主要前体.
- 在BE患者中,癌症进展的风险是高度可变的,从每年<0.5%的非扩张性BE到更高的风险的扩张不良或不良分子概况.
- 目前的监管策略需要改进,以准确地分层风险.
研究的目的:
- 审查巴雷特食道风险分层模型的演变.
- 总结当代临床,组织学和分子风险评估方法.
- 突出风险适应监控和个性化管理的新兴技术.
主要方法:
- 关于巴雷特食道风险分层的历史和当前文献的综述.
- 对已确定的临床预测因素 (年龄,性别,吸烟,细分长度,发育不良) 的分析.
- 评估先进的生物标记测定 (p53 IHC,组织系统病理学,甲基化) 和新的内镜/非内镜采样技术.
主要成果:
- 临床因素对于风险预测至关重要.
- 生物标志物测试提供了超越传统组织学风险分层.
- 像先进的成像和基于囊的采样等新兴技术显示出可能彻底改变监视的潜力.
结论:
- 巴雷特的食道管理正在过渡到个性化,生物标志物引导的护理.
- 将临床,组织学和分子数据与人工智能和现实世界的验证相结合是关键.
- 这种个性化的方法有望提高监测准确度,减少过度治疗,并改善早期食道腺癌的检测.
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