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首页> 外文期刊>The Open Pathology Journal >Recent Developments in Understanding Paediatric Barrett's Oesophagus
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Recent Developments in Understanding Paediatric Barrett's Oesophagus

机译：了解小儿巴雷特食管的最新进展

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Barrett’s oesophagus (BO) is an acquired pre-malignant condition in which metaplastic columnar epitheliumreplaces the normal squamous mucosa as a consequence of chronic gastro-oesophageal reflux. The pre-malignant qualityof BO is demonstrated in untreated adults with BO which are at risk of Barrett-associated adenoacarcinoma (BAA).This review addresses the epidemiological, clinical, endoscopic and histological features of paediatric BO. Recentmolecular developments and future directions that might lead to a better understanding of this condition are alsodiscussed.A recent estimate of the prevalence of columnar lined BO in the paediatric population in South Yorkshire (England) foundthis to be 0.0024% among all children in this geographical area, 0.8% in those children referred for endoscopy and 5.5%in the subgroup of children with GORD. BO was more prevalent in males than in females and risk factors were identified.Investigations in adult patients with BO have suggested that a key event that leads to the evolution of multiple aneuploidpopulations and to progression from metaplasia → dysplasia → adenocarcinoma is associated with a multistep process ofgenetic instability, which leads to a clonal expansion of the abnormal population. Genomic instability has not yet beendemonstrated in paediatric BO.Strong contenders for early events in neoplastic progression in BO include loss of p16 tumour suppressor function, HER2amplification, loss of function of TP 53 and O6 methylguanine methyl transferase (MGMT) promotor gene silencing.A clear genetic progression route has not yet emerged for BO. Nevertheless, many of the common abnormalities found inBarrett’s associated adenocarcinoma have been shown to be present in BO adjacent to carcinoma
机译：巴雷特食管（BO）是一种获得性恶变前疾病，其中由于慢性胃食管反流，化生的柱状上皮代替了正常的鳞状粘膜。未治疗的成人BO患巴雷特相关腺癌（BAA）的风险得到证明，其BO的恶变前质量。本研究针对儿童BO的流行病学，临床，内镜和组织学特征。还讨论了可能会更好地了解这种情况的最新分子发展情况和未来方向。最近对南约克郡（英格兰）儿科人群中柱状内衬BO患病率的最新估计发现，在该地理区域的所有儿童中，这一比例为0.0024％ ，接受内窥镜检查的儿童为0.8％，而GORD儿童的亚组为5.5％。 BO在男性中比女性更普遍，并且确定了危险因素。对成人BO的研究表明，导致多倍体非整倍体进化和由化生→发育异常→腺癌发展的关键事件与多步过程相关。遗传不稳定性，导致异常种群的克隆性扩张。小儿BO尚无基因组不稳定的证据，BO肿瘤进展早期事件的主要竞争者包括p16抑癌功能丧失，HER2扩增，TP 53和O6甲基鸟嘌呤甲基转移酶（MG6）启动子基因沉默功能丧失。 BO的遗传进化途径尚未出现。尽管如此，巴雷特相关腺癌中发现的许多常见异常均已显示在癌旁的BO中

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