食管腺癌
当巴雷特食管中的异常细胞快速而不受控制的生长并侵入食管较深层时,即癌症发生。该类型食管癌称为食管腺癌(EAC),其可扩散到食管以外。
虽然仍认为较罕见,但食管腺癌是美国发病率增长最快的癌症。13,14在1975年至2001年间,食管腺癌的发病率上升约6倍。10此外,死亡率增加7倍以上。15巴雷特食管患者患食管腺癌的风险比未患该病的患者高出30至125倍。16确诊食管癌后,只有18%患者存活5年以上。14
一个好消息是有可行的治疗方法。射频消融已证明可根除巴雷特食管,并显著性降低进展为高度分化不良和食管腺癌的风险。8,17,18
参考文献:
1. Dymedex Market Development Consulting, Strategic Market Assessment, Barrx, October 30, 2014. References 1, 3-5, 7-13, 15, 16, 20-23, 25, 27-29, 40-44, 46, 48-50, 54-59, 62-66, 68-75, 78, 79, 81, 82, 87-89, and 97 from the full citation list, access at http://www.medtronic.com/giclaims.
2. Spechler SJ. Barrett’s esophagus. N Engl J Med. 2002;346(11):836-42.
3. Dymedex Market Development Consulting, GERD Sizing and Segmentation for pH Testing, February 13 2015.
4. SEER Cancer Statistics Factsheets: Esophageal Cancer. National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/statfacts/html/esoph.html.
5. De Jonge PJ, van Blankenstein M, Looman CW, Casparie MK, Meijer GA, Kuipers EJ. Risk of malignant progression in patients with Barrett’s oesophagus: a Dutch nationwide cohort study. Gut. 2010;59:1030-6.
6. Hvid-Jensen F, Pedersen L, Drewes AM, Sorensen HT, Funch-Jensen P. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Engl J Med. 2011;365:1375-83.
7. Wani S, Falk G, Hall M, Gaddam S, Wang A, Gupta N, et al. Patients with nondysplastic Barrett’s esophagus have low risks for developing dysplasia or esophageal adenocarcinoma. Clin Gastroenterol Hepatol. 2011;9(3):220-7.
8. Shaheen NJ, Richter JE. Barrett’s oesophagus. Lancet. 2009;373(9666):850-61.
9. Spechler SJ, Souza RF. Barrett’s esophagus. NEJM. 2014;371:836-45.
10. Pohl H, Welch HG. The role of over diagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J Natl Cancer Inst. 2005;97:142-6.
11. Shaheen NJ, Falk GW, Iyer PG, Gerson LB. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. The American Journal Of Gastroenterology. 2016;111(1):30-50. doi:10.1038/ajg.2015.322.
12. Wani S, Qumseya B, Sultan S, et al. Endoscopic eradication therapy for patients with Barrett’s esophagus-associated dysplasia and intramucosal cancer. Gastrointestinal Endoscopy. 2018;87(4):907-931.
13. Reid BJ, Weinstein WM. Barrett’s esophagus and adenocarcinoma. Gastroenterology Clinics of North America. 1987;38:477-92.
14. "What Are the Key Statistics about Cancer of the Esophagus?" Cancer.org. 2006. American Cancer Society. Accessed October 2007.
15. Gilbert EW, Luna RA, Harrison VL, Hunter JG. Barrett’s esophagus: a review of the literature. J Gastrointest Surg. 2011;15:708-18.
16. Eisen GM. Ablation therapy for Barrett's esophagus. Gastrointestinal Endosc. 2003;58:760-9.
17. Phoa KN, van Vilsteren FG, Weusten BL, Bisschops R, Schoon EJ, Ragunath K, et al. Radiofrequency ablation vs endoscopic surveillance for patients with Barrett esophagus and low-grade dysplasia: a randomized clinical trial. JAMA. 2014;311(12)1209-17. doi:10.1001/jama.2014.2511.
18. Wolf WA, Pasricha S, Cotton C, Li N, Triadafilopoulos G, Raman Muthusamy V, et al. Incidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett’s Esophagus. Gastroenterology. 2015;149(7):1752-1761.