Surveillance in Barrett's Esophagus: Challenges, Progress, and Possibilities.
Gastroenterology
; 164(5): 707-718, 2023 04.
Article
en En
| MEDLINE
| ID: mdl-36746210
ABSTRACT
Endoscopic surveillance of Barrett's esophagus, aiming to detect prevalent dysplasia and adenocarcinoma, followed by effective endoscopic treatment, is an integral part of the esophageal adenocarcinoma prevention paradigm. However, several limitations, such as the subtle appearance of dysplasia, sampling error (inherent in current surveillance protocols), and noncompliance with surveillance recommendations, lead to missed dysplasia and neoplasia, reducing the effectiveness of surveillance as currently practiced. Careful endoscopic assessment with high-resolution white-light endoscopy, dye-based or electronic chromoendoscopy, and comprehensive sampling of the BE mucosa, remains the cornerstone of endoscopic surveillance. Emerging innovations in this area span the gamut of more efficient sampling methods, advanced imaging tools, artificial intelligence, and molecular marker-powered approaches as adjuncts, to identify prevalent and predict incident dysplasia or adenocarcinoma. Development and implementation of validated quality indicators will allow additional advancement of this critical field. These approaches will hopefully enable efficient and effective cancer prevention and treatment.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Esófago de Barrett
/
Neoplasias Esofágicas
/
Adenocarcinoma
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Guideline
/
Prognostic_studies
/
Screening_studies
Límite:
Humans
Idioma:
En
Revista:
Gastroenterology
Año:
2023
Tipo del documento:
Article