Barrett食管内镜诊断研究进展

Barrett食管(BE)是食管腺癌的癌前病变,一旦发展为食管腺癌,患者5年生存率小于20%,给患者造成了比较大的精神和经济压力.BE提出已有60余年,但对其认识并不全面.因此,提高对BE认识,以早期诊断BE,对降低食管腺癌发病率具有重要意义.本文就BE定义、内镜下的诊断进展作简要综述,以便临床医师更好的把握该疾病的诊断治疗.     

Barrett食管的临床特征

Barrett食管(Barrett’s esophagus,BE)的主要病因是胃食管反流(gastroesophageal refluxdisease,GERD),Barrett食管与食管腺癌密切相关〔1〕。近年来,Barrett食管及其相关食管腺癌的发生率增长很快,在西方国家尤其明显,在有反流症状的患者中Barrett食管的发生率可达15%〔2〕。每年大约有1%的Barrett食管患者发展为食管腺癌〔3〕,因此,早期诊断和治疗Barrett食管以及治疗早期食管腺癌显得非常必要。本文主要介绍Barrett食管的定义、分类、流行病学、临床表现、内镜下表现、组织学特点、Barrett食管与食管腺癌的监测及其Barrett食管临…     

Barrett食管二例报告

Barrett食管（又称柱状上皮食管），近年来国外学者有较多报导，国内仅见一例报告（1），本文收集经手术，病理证实的二例介绍如下。     

胃食管反流病与Barrett食管的内镜诊断进展

胃食管反流病（Gastroesophageal reflus disease,GERD）系指食管下部黏膜破损呈界限清晰的条状发红或带有白苔,据其有无白苔或发红的破损情况分为2类：（1）有糜烂的称反流性食管炎（RE）;（2）无黏膜破损的称非糜烂性反流性食管病（Nonersive esophageal reflus disease,NERD）。     

Barrett氏食管四例报告

Barrett's esophagus is a complication of gastroesophageal reflux. Radiological findings included gastroesophageal reflux and oesophagitis. It is an important precancerous disorder in the development of esophageal adenocarcinoma. The authors reported 4 cases confirmed by endoscopy and pathology.     

胃镜下微波治疗Barrett食管术的应用和护理

Barrett食管是指食管下段的复层鳞状上皮被特殊的柱状上皮替代的一种病理现象。此病最严重的有10％的病人可以癌变，通常认为是癌前病变，所以有症状要早期进行检查治疗。Barrett食管多是由长期反流性食管炎造成的，是胃食管反流病的并发症之一。在胃食管反流病患者中，至少有10％发生Barrett食管，发病率约为18／10万，发病年龄为40～60岁。     

光动力学疗法治疗Barrett食管和食管早期癌

Barrett食管(Barrettsesophagus,BE)是指食管复层鳞状上皮被化生的柱状上皮替代的一种病理现象。食管癌是最常见的恶性肿瘤之一,我国是食管癌的高发国,也是本病死亡率最高的国家。以前食管癌中腺癌少见,但20世纪80年代以后食管腺癌(esophagealadenocarcinoma,EA)发病率迅速上升     

不同反流物对食管粘膜的损害及与食管腺癌关系的研究进展

阐述了不同类型反流物对食管上皮细胞的损伤，评价在反流性食管炎中基因的突变，以及与食管腺癌的联系。     

Barrett食管的光动力学治疗

探讨光动力学疗法（PDT）治疗Barrett食管的有效性。对比各种类型光敏剂治疗Barrett食管的优点和不足，比较PDT与其他内镜下治疗Barrett食管的疗效及其并发症。PDT疗法Barrett食管具有损伤小，造成穿孔等并发症的机会较小，且对于一些边界不清或者多病灶的病变可减少治疗遗漏等特点，但可造成食管狭窄且某些光敏剂需要长达一个月的避光期造成患者治疗期间不方便。PDT是一种可重复性，侵袭性小，特异性强而疗效可靠的一种治疗Barratt食管的方法，不仅对不典型增生而且对早期癌都有疗效，与其他内镜下治疗联合可提高治疗效果。     

Barrett食管36例内镜检查及临床分析

Barrett食管（Barrett＇s esophagus,BE）是指鳞柱状上皮移行至胃食管连接部近端且伴有肠腺化生的疾病。BE是一种癌前病变,与食管腺癌关系密切。国外研究报道,癌变率每年约为1／104人,较一般人群高出30—125倍,80％的食管腺癌产生于BE,而40％的胃食管交界处腺癌与BE有关。近年来,BE的发病率呈逐年上升趋势,已成为西方国家食管腺癌发病率大幅度增高的直接原因。笔者收集2004年2月-2007年2月资料较为完整的36例,就其病因、诊断、治疗及进展等方面作一分析,旨在提高BE的诊治水平。     

Barrett食管1例

患者 男,48岁.1月前出现胸骨后疼痛,现吞咽困难,体检无特殊性.食道钡餐造影:食管下端近贲门处局限性狭窄,呈偏心性,形态较固定,钡剂通过迟缓,局部粘膜呈网织状、颗粒状,不规则,无明显粘膜破坏、中断,贲门开放自然,卧位见胃食管返流.意见:符合Barrett食管,但不排除食管癌,建议胃镜检查.胃镜检查所见:食管粘膜光滑,血管纹理清晰,距门齿42cm达贲门,开闭自然,齿状线上移至38cm,粘膜糜烂,可见粘膜瘢痕,取B4,质软,诊断:Barrett食管.病理诊断:(食管下端)粘膜慢性炎.     

Postesophageal narrowing associated with Barrett esophagus.

Two children have been found to have partially obstructing lesions beyond the esophagus in association with mid-esophageal stricture. Both were found to have columnar epithelium-lined (Barrett) esophagus, and gastro-esophageal reflux. The more distal obstruction, in the pylorus and descending duodenum respectively, may have contributed to the development of the Barrett esophagus. It is recommended that any barium study of the esophagus which reveals an unexplained stricture should include visualization through the duodenojejunal junction as an aid to diagnosis, management, and understanding.     

The radiologic diagnosis of Barrett esophagus: importance of mucosal surface abnormalities on air-contrast barium studies

Patients with Barrett esophagus are predisposed to the development of esophageal adenocarcinoma. Identification of these patients before this complication develops is essential. We prospectively made the diagnosis of Barrett esophagus on routine biphasic upper gastrointestinal series in nine patients in whom a mucosal surface pattern alteration was the only radiologic abnormality on the esophagogram. The diagnosis was confirmed by biopsy in eight patients and during surgery in one patient. Only a third of the patients had symptoms related to the esophagus. Two types of surface changes were noted. A reticular pattern was present in six cases and a villous pattern in five cases. Both patterns were noted in two patients. This series was obtained in a 5-year interval during which there were 15 additional patients with Barrett esophagus and corresponding esophagograms. None of these patients had normal results on esophagograms. Recognition of these subtle surface patterns, particularly in the absence of other reflux-induced abnormalities, may improve detection of Barrett esophagus and aid in the selection of patients for subsequent surveillance.     

Barrett carcinoma of the esophagus: clinical and radiographic analysis of 34 cases

Review of 34 cases of pathologically proved Barrett-type adenocarcinoma of the esophagus seen at the University of Michigan during 1962-1983 revealed that it constituted 5% of all carcinomas of the esophagus and 20% of all adenocarcinomas involving the esophagus during that period. Despite many similarities to conventional squamous cell carcinoma and gastric cardiac carcinoma, certain distinguishing features were identified. Radiologically, diagnosis of Barrett carcinoma should be suggested when a patient with a longstanding history of gastroesophageal reflux, chronic esophagitis, and hiatus hernia with or without features of Barrett esophagus demonstrates a long vertical segment of esophageal involvement by an infiltrating or varicoid-appearing lesion. This review analyzes the clinical and radiologic distinguishing features of Barrett carcinoma and compares those of gastric cardiac carcinoma and conventional squamous cell carcinoma of the esophagus.