• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Seminars in Gastrointestinal Disease >Controversies in Barrett's esophagus: management of high grade dysplasia.
【24h】

Controversies in Barrett's esophagus: management of high grade dysplasia.

机译：巴雷特食管的争议：高度不典型增生的管理。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Barrett's esophagus is the premalignant lesion for adenocarcinoma of the esophagus and the esophagogastric junction. The incidence of esophageal adenocarcinoma has been rapidly rising in the Western world over the last two decades, and Barrett's esophagus is the only known premalignant lesion for this cancer. Esophageal adenocarcinoma develops through the metaplasia-dysplasia sequence with progression from no dysplasia, low grade dysplasia, high grade dysplasia, and ultimately to esophageal adenocarcinoma. The diagnosis and management of high grade dysplasia (HGD) in patients with Barrett's esophagus is extremely controversial. Patients with HGD within Barrett's esophagus are at the highest risk for development of esophageal adenocarcinoma if concurrent adenocarcinoma doesn't already exist. Given the high likelihood of metastatic disease and poor prognosis associated with invasive cancer, detection of HGD within Barrett's esophagus is considered by many as the final endpoint requiring definitive therapy in the form of surgical resection. However, other limited data seem to suggest that a number of patients with HGD may actually regress or persist and not develop cancer, thus suggesting a less aggressive approach for management. Finally with the advent of local endoscopic therapy, reversal therapy is being studied in patients with HGD and may be validated for this major indication. Currently, surgery remains the goal standard and the most definitive therapy for HGD. This articles critically reviews the risks and benefits associated with each approach of managing HGD.
机译：巴雷特食管是食管腺癌和食管胃交界处的癌前病变。在过去的二十年里，食管腺癌的发病率在西方世界迅速上升，巴雷特食管是该癌唯一已知的癌前病变。食管腺癌通过不典型增生，低度增生，高度不典型增生，最终发展为食管腺癌，通过化生增生序列发展。巴雷特食管患者高度不典型增生（HGD）的诊断和治疗引起了极大争议。如果尚不存在并发腺癌，则在巴雷特食管内患有HGD的患者发生食管腺癌的风险最高。鉴于转移性疾病的可能性较高以及与浸润性癌相关的预后较差，许多人认为在Barrett食道内检测HGD是需要以手术切除形式进行彻底治疗的最终终点。但是，其他有限的数据似乎表明，许多患有HGD的患者实际上可能会消退或持续存在而不发展为癌症，因此表明治疗的积极性较低。最终，随着局部内窥镜治疗的出现，正在对HGD患者进行逆转疗法的研究，并可能对该主要适应症进行验证。目前，手术仍然是HGD的目标标准和最明确的治疗方法。本文严格审查与管理HGD的每种方法相关的风险和收益。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号