RESUMEN
BACKGROUND AND AIM: The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively. METHODS: This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed. RESULTS: Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection. CONCLUSIONS: The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.
Asunto(s)
Adenocarcinoma/epidemiología , Esófago de Barrett/epidemiología , Estudios de Cohortes , Neoplasias Esofágicas/epidemiología , Adenocarcinoma/diagnóstico , Adenocarcinoma/etiología , Adenocarcinoma/patología , Anciano , Esófago de Barrett/complicaciones , Esófago de Barrett/diagnóstico , Esófago de Barrett/patología , Endoscopía del Sistema Digestivo , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/etiología , Neoplasias Esofágicas/patología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios ProspectivosRESUMEN
The sessile serrated adenoma/polyp (SSA/P) has been thought as the relatively new precursor for the colorectal cancer. In the current review, the well-known pathological features including the histological definition of the SSA/P are described using the previous reports. Although the SSA/P is thought one of pre-cancerous lesions of the colorectal carcinoma, the decisive or documentary lesion like "carcinoma in adenoma" is very rare. In this review, the strict case of the carcinoma derived from the SSA/P is demonstrated using our cases. Although the genetic investigations of the SSA/P have shown the new pathway of colorectal carcinogenesis and these concepts are thought to be almost right, the verification for them should be performed using "the carcinoma in SSA/P" like the present case.