Early Diagnosis of Barrett's Carcinoma

Abstract

Barrett's esophagus (BE) is a complication of long-standing pathologic gastroesophageal reflux and is found in approximately 10% of patients with reflux esophagitis. As it is a premalignant condition with a 30- to 100-fold increased risk of developing adenocarcinoma, detection is important. Endoscopy is most sensitive for diagnosing BE. Biopsy specimens should be taken at various levels to look for intestinal-type epithelium, dysplasia, or carcinoma. Although an early carcinoma may present as a small ulcer or a small polypoid mass, carcinoma may be present without any endoscopic suspicion. No histologic markers have so far been found that are useful in screening for dysplasia, but flow cytometry may prove of use in the future. As dysplasia and carcinoma are almost always related to intestinal-type epithelium, patients with this epithelium may benefit from an endoscopic follow-up program.

Key Words:

• Barrett carcinoma
• Barrett's esophagus