Evolving management of metaplasia and dysplasia in Barrett's epithelium

World J Gastroenterol. 2016 Dec 21;22(47):10316-10324. doi: 10.3748/wjg.v22.i47.10316.

Abstract

Oesophageal cancer affects more than 450000 people worldwide and despite continued medical advancements the incidence of oesophageal cancer is increasing. Oesophageal cancer has a 5 year survival of 15%-25% and now globally attempts are made to more aggressively diagnose and treat Barrett's oesophagus the known precursor to invasive disease. Currently diagnosis the of Barrett's oesophagus is predominantly made after endoscopic visualisation and histopathological confirmation. Minimally invasive techniques are being developed to improve the viability of screening programs. The management of Barrett's oesophagus can vary greatly dependent on the presence and severity of dysplasia. There is no consensus between the major international medical societies to determine and agreed surveillance and intervention pathway. In this review we analysed the current literature to demonstrate the evolving management of metaplasia and dysplasia in Barrett's epithelium.

Keywords: Barrett’s; Dysplasia; Metaplasia; Oesophageal cancer; Oesophagus.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / surgery*
  • Barrett Esophagus / diagnosis
  • Barrett Esophagus / epidemiology
  • Barrett Esophagus / therapy*
  • Disease Progression
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / epidemiology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / adverse effects
  • Esophagectomy / methods*
  • Esophagoscopy* / adverse effects
  • Esophagus / drug effects*
  • Esophagus / pathology
  • Esophagus / surgery*
  • Humans
  • Metaplasia
  • Predictive Value of Tests
  • Proton Pump Inhibitors / adverse effects
  • Proton Pump Inhibitors / therapeutic use*
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Watchful Waiting*

Substances

  • Proton Pump Inhibitors

Supplementary concepts

  • Adenocarcinoma Of Esophagus