Diagnosis and Management of Barrett's Esophagus

Overview

Journal Surg Clin North Am

Specialty General Surgery

Date 2012 Oct 3

PMID 23026274

Citations 5

Authors

Eric M Nelsen

Robert H Hawes

Prasad G Iyer

Affiliations

Soon will be listed here.

Abstract

Barrett esophagus is characterized by the replacement of squamous mucosa in the esophagus by specialized intestinal metaplasia. Its clinical significance lies in it being the strongest risk factor for and known precursor for esophageal adenocarcinoma. Diagnosis requires endoscopic confirmation of columnar metaplasia in the distal esophagus and histologic confirmation of specialized intestinal metaplasia. Recommendations for the management of subjects diagnosed with Barrett esophagus include periodic endoscopic surveillance to detect the development of high-grade dysplasia or adenocarcinoma. Careful endoscopic evaluation with high-resolution endoscopy and endoscopic resection is recommended in the evaluation of subjects with high-grade dysplasia and early adenocarcinoma.

Citing Articles

Barrett's Esophageal Adenocarcinoma Involving a White Globe Appearance within the Long-Segment Barrett's Esophagus.

Kubota Y, Tanabe S, Harada Y, Nakatani S, Furue Y, Wada T Case Rep Gastroenterol. 2020; 14(3):510-515.

PMID: 33250690 PMC: 7670350. DOI: 10.1159/000508861.

Balloon catheter-based radiofrequency ablation monitoring in porcine esophagus using optical coherence tomography.

Lo W, Uribe-Patarroyo N, Hoebel K, Beaudette K, Villiger M, Nishioka N Biomed Opt Express. 2019; 10(4):2067-2089.

PMID: 31086717 PMC: 6484999. DOI: 10.1364/BOE.10.002067.

Incidence and predictors of osteoporotic fractures in patients with Barrett's oesophagus: a population-based nested case-control study.

Kumar S, Drake M, Schleck C, Johnson M, Alexander J, Katzka D Aliment Pharmacol Ther. 2017; 46(11-12):1094-1102.

PMID: 28980336 PMC: 5683094. DOI: 10.1111/apt.14345.

Barrett's oesophagus: Current controversies.

Amadi C, Gatenby P World J Gastroenterol. 2017; 23(28):5051-5067.

PMID: 28811703 PMC: 5537175. DOI: 10.3748/wjg.v23.i28.5051.

Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities.

Napier K, Scheerer M, Misra S World J Gastrointest Oncol. 2014; 6(5):112-20.

PMID: 24834141 PMC: 4021327. DOI: 10.4251/wjgo.v6.i5.112.

References

Peters F, Kara M, Rosmolen W, Ten Kate F, Krishnadath K, van Lanschot J . Stepwise radical endoscopic resection is effective for complete removal of Barrett's esophagus with early neoplasia: a prospective study. Am J Gastroenterol. 2006; 101(7):1449-57. DOI: 10.1111/j.1572-0241.2006.00635.x. View

Montgomery E, Goldblum J, Greenson J, Haber M, Lamps L, Lauwers G . Dysplasia as a predictive marker for invasive carcinoma in Barrett esophagus: a follow-up study based on 138 cases from a diagnostic variability study. Hum Pathol. 2001; 32(4):379-88. DOI: 10.1053/hupa.2001.23511. View

Dellon E, Shaheen N . Does screening for Barrett's esophagus and adenocarcinoma of the esophagus prolong survival?. J Clin Oncol. 2005; 23(20):4478-82. DOI: 10.1200/JCO.2005.19.059. View

Yousef F, Cardwell C, Cantwell M, Galway K, Johnston B, Murray L . The incidence of esophageal cancer and high-grade dysplasia in Barrett's esophagus: a systematic review and meta-analysis. Am J Epidemiol. 2008; 168(3):237-49. DOI: 10.1093/aje/kwn121. View

Rubenstein J, Dahlkemper A, Kao J, Zhang M, Morgenstern H, McMahon L . A pilot study of the association of low plasma adiponectin and Barrett's esophagus. Am J Gastroenterol. 2008; 103(6):1358-64. DOI: 10.1111/j.1572-0241.2008.01823.x. View

Galipeau P, Li X, Blount P, Maley C, Sanchez C, Odze R . NSAIDs modulate CDKN2A, TP53, and DNA content risk for progression to esophageal adenocarcinoma. PLoS Med. 2007; 4(2):e67. PMC: 1808095. DOI: 10.1371/journal.pmed.0040067. View

Pandolfino J, El-Serag H, Zhang Q, Shah N, Ghosh S, Kahrilas P . Obesity: a challenge to esophagogastric junction integrity. Gastroenterology. 2006; 130(3):639-49. DOI: 10.1053/j.gastro.2005.12.016. View

Shaheen N, Green B, Medapalli R, Mitchell K, Wei J, Schmitz S . The perception of cancer risk in patients with prevalent Barrett's esophagus enrolled in an endoscopic surveillance program. Gastroenterology. 2005; 129(2):429-36. DOI: 10.1016/j.gastro.2005.05.055. View

Inadomi J, Sampliner R, Lagergren J, Lieberman D, Fendrick A, Vakil N . Screening and surveillance for Barrett esophagus in high-risk groups: a cost-utility analysis. Ann Intern Med. 2003; 138(3):176-86. DOI: 10.7326/0003-4819-138-3-200302040-00009. View

10.

Desai T, Krishnan K, Samala N, Singh J, Cluley J, Perla S . The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis. Gut. 2011; 61(7):970-6. DOI: 10.1136/gutjnl-2011-300730. View

11.

Peters J, Avisar N . The molecular pathogenesis of Barrett's esophagus: common signaling pathways in embryogenesis metaplasia and neoplasia. J Gastrointest Surg. 2009; 14 Suppl 1:S81-7. DOI: 10.1007/s11605-009-1011-7. View

12.

Rubenstein J, Sonnenberg A, Davis J, McMahon L, Inadomi J . Effect of a prior endoscopy on outcomes of esophageal adenocarcinoma among United States veterans. Gastrointest Endosc. 2008; 68(5):849-55. PMC: 3481546. DOI: 10.1016/j.gie.2008.02.062. View

13.

El-Serag H, Kvapil P, Hacken-Bitar J, Kramer J . Abdominal obesity and the risk of Barrett's esophagus. Am J Gastroenterol. 2005; 100(10):2151-6. DOI: 10.1111/j.1572-0241.2005.00251.x. View

14.

Coleman H, Bhat S, Johnston B, McManus D, Gavin A, Murray L . Tobacco smoking increases the risk of high-grade dysplasia and cancer among patients with Barrett's esophagus. Gastroenterology. 2011; 142(2):233-40. DOI: 10.1053/j.gastro.2011.10.034. View

15.

Tran T, Spechler S, Richardson P, El-Serag H . Fundoplication and the risk of esophageal cancer in gastroesophageal reflux disease: a Veterans Affairs cohort study. Am J Gastroenterol. 2005; 100(5):1002-8. DOI: 10.1111/j.1572-0241.2005.41007.x. View

16.

Song S, Guha S, Liu K, Buttar N, Bresalier R . COX-2 induction by unconjugated bile acids involves reactive oxygen species-mediated signalling pathways in Barrett's oesophagus and oesophageal adenocarcinoma. Gut. 2007; 56(11):1512-21. PMC: 2095641. DOI: 10.1136/gut.2007.121244. View

17.

Rubenstein J, Inadomi J . Potential for lead-time and length-time biases in outcomes in esophageal adenocarcinoma. Am J Gastroenterol. 2009; 104(12):3106-7. DOI: 10.1038/ajg.2009.488. View

18.

Corley D, Levin T, Habel L, Weiss N, Buffler P . Surveillance and survival in Barrett's adenocarcinomas: a population-based study. Gastroenterology. 2002; 122(3):633-40. DOI: 10.1053/gast.2002.31879. View

19.

Schulmann K, Sterian A, Berki A, Yin J, Sato F, Xu Y . Inactivation of p16, RUNX3, and HPP1 occurs early in Barrett's-associated neoplastic progression and predicts progression risk. Oncogene. 2005; 24(25):4138-48. DOI: 10.1038/sj.onc.1208598. View

20.

Reid B, Levine D, Longton G, Blount P, Rabinovitch P . Predictors of progression to cancer in Barrett's esophagus: baseline histology and flow cytometry identify low- and high-risk patient subsets. Am J Gastroenterol. 2000; 95(7):1669-76. PMC: 1783835. DOI: 10.1111/j.1572-0241.2000.02196.x. View