Download PDF
Z Gastroenterol 2007; 45(12): 1264-1272
DOI: 10.1055/s-2007-963638
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Barrett-Karzinom - Diagnose, Screening, Surveillance, endoskopische Therapie, Prävention

Barrett Carcinoma - Diagnosis, Screening, Surveillance, Endoscopic Treatment, PreventionU. Peitz1 , P. Malfertheiner1
  • 1Klinik für Gastroenterologie, Hepatologie und Infektiologie, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg
Further Information

Publication History

Manuskript eingetroffen: 30.8.2007

Manuskript akzeptiert: 5.10.2007

Publication Date:
13 December 2007 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Das Adenokarzinom des unteren Ösophagus kann auch als Barrett-Karzinom bezeichnet werden, da es sich aus einem Barrett-Ösophagus entwickelt. Der Barrett-Ösophagus als Präneoplasie wird aktuell definiert als endoskopisch sichtbare Zylinderepithelmetaplasie im unteren Ösophagus, in der sich histologisch eine intestinale Metaplasie nachweisen lässt. Eine andere histologische Form der Zylinderepithelmetaplasie im unteren Ösophagus ist kardiatypische Mukosa, die vermutlich der intestinalen Metaplasie vorausgeht, aber keine Becherzellen wie diese enthält. Die Konversionsrate vom Barrett-Ösophagus zum Barrett-Karzinom beträgt 0,5 bis1 % pro Jahr. Patienten mit Refluxbeschwerden sollten frühzeitig endoskopiert werden, um einen Barrett-Ösophagus zu suchen (Screening). Die Identifizierung eines Barrett-Ösophagus hat dann regelmäßige endoskopische Kontrollen zur Folge, deren Intervalle durch Leitlinien festgelegt sind (Surveillance). Ziel ist die Früherkennung einer Neoplasie. Auf das Epithel oder die Mukosa beschränkte Neoplasien können meist endoskopisch reseziert werden. Die histologisch am Resektat bestimmte Infiltrationstiefe erlaubt eine Abschätzung des Lymphknotenmetastasierungsrisikos und ist somit essenziell zur abschließenden Beurteilung, ob der endoskopische Eingriff als kurativ angesehen werden kann. Das Metastasierungsrisiko ist individuell gegenüber dem Morbiditäts- und Mortalitätsrisiko bei einer chirurgischen Resektion abzuwägen. Die rasche Zunahme der Inzidenz des Barrett-Karzinoms in westlichen Ländern deutet auf Lebensstil-Faktoren, insbesondere Übergewicht, als Ursache hin. Daten aus Interventionsstudien zur Prävention stehen jedoch noch aus.

Abstract

An adenocarcinoma of the distal esophagus may also be designated as Barrett’s carcinoma as it evolves from Barrett’s esophagus. Barrett’s esophagus currently is defined as a columnar metaplasia of the distal esophagus, as identified by endoscopy, that, upon histopathology, is confirmed to contain intestinal metaplasia. A different histological entity of columnar metaplasia of the distal esophagus is cardia-type mucosa which probably preceeds intestinal metaplasia, but lacks goblet cells typical for the latter. The conversion rate from Barrett’s esophagus to Barrett’s carcinoma amounts to 0.5 to 1 % per year. Patients with reflux symptoms should undergo early endoscopy in order to search for Barrett’s esophagus (screening). In those cases where Barrett’s esophagus is identified, regular endoscopic controls should be scheduled (surveillance). The intervals for this have been defined by recent consented guidelines. The aim is to detect neoplasia early. Neoplasia confined to the epithelium or mucosal layer can mostly be treated by endoscopic resection. The depth of infiltration, as determined by histolopathology of the resected specimen, allows one to estimate the risk of lymph node metastasis, and therefore is crucial for the final judgment as to whether the endoscopic intervention may be considered curative. Individually, the risk of metastasis has to be weighed against the risk of morbidity and mortality conferred by the alternative surgical resection. The rapid increase of the incidence of Barrett’s carcinoma in Western countries suggests that life style factors, in particular overweight, having a causal role. Data from interventional trials on prevention are, however, pending.

Schlüsselwörter

Adenokarzinom - Barrett-Ösophagus - Screening - Surveillance - endoskopische Resektion

Key words

adenocarcinoma - Barrett’s esophagus - screening - surveillance - endoscopic resection

Literatur

  • 1 Schlansky B, Dimarino A J Jr, Loren D. et al . A survey of oesophageal cancer: pathology, stage and clinical presentation.  Aliment Pharmacol Ther. 2006;  23 (5) 587-593
    Google Scholar
  • 2 Barret N R. Chronic peptic ulcer of the oesophagus and ‘oesophagitis’.  Br J Surg. 1950;  38 (150) 175-182
    Google Scholar
  • 3 Sampliner R E. Updated guidelines for the diagnosis, surveillance, and therapy of Barrett’s esophagus.  Am J Gastroenterol. 2002;  97 (8) 1888-1895
    Google Scholar
  • 4 Koop H, Schepp W, Muller-Lissner S. et al . Consensus conference of the DGVS on gastroesophageal reflux.  Z Gastroenterol. 2005;  43 (2) 163-164
    Google Scholar
  • 5 Messmann H, Ell C, Fein M. et al . Topic Complex VI: Barrett esophagus.  Z Gastroenterol. 2005;  43 (2) 184-190
    Google Scholar
  • 6 Watson A, Heading R C, Shepherd N A. Guidelines for the diagnosis and management of Barrett’s columnar-lined oesophagus.  2005;  , http://www.bsg.org.uk
    Google Scholar
  • 7 Boyer J, Robaszkiewicz M. Guidelines of the French Society of Digestive Endoscopy: monitoring of Barrett’s esophagus. The Council of the French Society of Digestive Endoscopy.  Endoscopy. 2000;  32 (6) 498-499
    Google Scholar
  • 8 Chandrasoma P T, Der R, Ma Y. et al . Histologic classification of patients based on mapping biopsies of the gastroesophageal junction.  Am J Surg Pathol. 2003;  27 (7) 929-936
    Google Scholar
  • 9 Chandrasoma P. Controversies of the cardiac mucosa and Barrett’s oesophagus.  Histopathology. 2005;  46 (4) 361-373
    Google Scholar
  • 10 Peitz U, Vieth M, Pross M. et al . Cardia-type metaplasia arising in the remnant esophagus after cardia resection.  Gastrointest Endosc. 2004;  59 (7) 810-817
    Google Scholar
  • 11 Shaheen N J, Crosby M A, Bozymski E M. et al . Is there publication bias in the reporting of cancer risk in Barrett’s esophagus?.  Gastroenterology. 2000;  119 (2) 333-338
    Google Scholar
  • 12 Lassen A, Hallas J, Muckadell O B. Esophagitis: incidence and risk of esophageal adenocarcinoma - a population-based cohort study.  Am J Gastroenterol. 2006;  101 (6) 1193-1199
    Google Scholar
  • 13 Malfertheiner de P, Peitz U. The interplay between Helicobacter pylori, gastro-oesophageal reflux disease, and intestinal metaplasia.  Gut. 2005;  54 Suppl 1 i13-i20
    Google Scholar
  • 14 Anandasabapathy S, Jhamb J, Davila M. et al . Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia.  Cancer. 2007;  109 (4) 668-674
    Google Scholar
  • 15 Sharma P, Dent J, Armstrong D. et al . The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria.  Gastroenterology. 2006;  131 (5) 1392-1399
    Google Scholar
  • 16 Theisen J, Stein H J, Dittler H J. et al . Preoperative chemotherapy unmasks underlying Barrett’s mucosa in patients with adenocarcinoma of the distal esophagus.  Surg Endosc. 2002;  16 (4) 671-673
    Google Scholar
  • 17 Hamilton R, Aaltonen L A. Tumors of the gastrointestinal system; WHO classification. Lyon; IARC Press 2000
    Google Scholar
  • 18 Rahden B H, Stein H J, Siewert J R. Surgical management of esophagogastric junction tumors.  World J Gastroenterol. 2006;  12 (41) 6608-6613
    Google Scholar
  • 19 Schlemper R J, Riddell R H, Kato von Y. et al . The Vienna classification of gastrointestinal epithelial neoplasia.  Gut. 2000;  47 (2) 251-255
    Google Scholar
  • 20 Bollschweiler E, Wolfgarten E, Gutschow C. et al . Demographic variations in the rising incidence of esophageal adenocarcinoma in white males.  Cancer. 2001;  92 (3) 549-555
    Google Scholar
  • 21 Devesa S S, Blot W J, Fraumeni J F Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States.  Cancer. 1998;  83 (10) 2049-2053
    Google Scholar
  • 22 Bytzer P, Christensen P B, Damkier P. et al . Adenocarcinoma of the esophagus and Barrett’s esophagus: a population-based study.  Am J Gastroenterol. 1999;  94 (1) 86-91
    Google Scholar
  • 23 Corley D A, Buffler P A. Oesophageal and gastric cardia adenocarcinomas: analysis of regional variation using the Cancer Incidence in Five Continents database.  Int J Epidemiol. 2001;  30 (6) 1415-1425
    Google Scholar
  • 24 Corley D A, Kubo A. Influence of site classification on cancer incidence rates: an analysis of gastric cardia carcinomas.  J Natl Cancer Inst. 2004;  96 (18) 1383-1387
    Google Scholar
  • 25 Nguyen A M, Luke C G, Roder D. Comparative epidemiological characteristics of oesophageal adenocarcinoma and other cancers of the oesophagus and gastric cardia.  Asian Pac J Cancer Prev. 2003;  4 (3) 225-231
    Google Scholar
  • 26 Bareiss D, Stabenow R, Muller R. et al . [Current epidemiology of carcinoma of the esophagus and cardia in Germany].  Dtsch Med Wochenschr. 2002;  127 (25 - 26) 1367-1374
    Google Scholar
  • 27 Chow W H, Blot W J, Vaughan T L. et al . Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia.  J Natl Cancer Inst. 1998;  90 (2) 150-155
    Google Scholar
  • 28 Jonge P J, Steyerberg E W, Kuipers E J. et al . Risk factors for the development of esophageal adenocarcinoma in Barrett’s esophagus.  Am J Gastroenterol. 2006;  101 (7) 1421-1429
    Google Scholar
  • 29 Guardino J M, Khandwala de F, Lopez R. et al . Barrett’s esophagus at a tertiary care center: association of age on incidence and prevalence of dysplasia and adenocarcinoma.  Am J Gastroenterol. 2006;  101 (10) 2187-2193
    Google Scholar
  • 30 Lagergren J, Bergstrom R, Nyren O. Association between body mass and adenocarcinoma of the esophagus and gastric cardia.  Ann Intern Med. 1999;  130 (11) 883-890
    Google Scholar
  • 31 Lagergren J, Bergstrom R, Lindgren A. et al . Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma.  N Engl J Med. 1999;  340 (11) 825-831
    Google Scholar
  • 32 Wu A H, Wan P, Bernstein L. A multiethnic population-based study of smoking, alcohol and body size and risk of adenocarcinomas of the stomach and esophagus (United States).  Cancer Causes Control. 2001;  12 (8) 721-732
    Google Scholar
  • 33 El Serag H B, Sonnenberg A. Opposing time trends of peptic ulcer and reflux disease.  Gut. 1998;  43 (3) 327-333
    Google Scholar
  • 34 Kendall B J, Whiteman D C. Temporal changes in the endoscopic frequency of new cases of Barrett’s esophagus in an Australian health region.  Am J Gastroenterol. 2006;  101 (6) 1178-1182
    Google Scholar
  • 35 Conio M, Cameron A J, Romero Y. et al . Secular trends in the epidemiology and outcome of Barrett’s oesophagus in Olmsted County, Minnesota.  Gut. 2001;  48 (3) 304-309
    Google Scholar
  • 36 Hurschler D, Borovicka J, Neuweiler J. et al . Increased detection rates of Barrett’s oesophagus without rise in incidence of oesophageal adenocarcinoma.  Swiss Med Wkly. 2003;  133 (37 - 38) 507-514
    Google Scholar
  • 37 Prach A T, MacDonald T A, Hopwood D A. et al . Increasing incidence of Barrett’s oesophagus: education, enthusiasm, or epidemiology?.  Lancet. 1997;  350 (9082) 933
    Google Scholar
  • 38 Soest E M, Dieleman J P, Siersema P D. et al . Increasing incidence of Barrett’s oesophagus in the general population.  Gut. 2005;  54 (8) 1062-1066
    Google Scholar
  • 39 Hagen J A, DeMeester S R, Peters J H. et al . Curative resection for esophageal adenocarcinoma: analysis of 100 en bloc esophagectomies.  Ann Surg. 2001;  234 (4) 520-530
    Google Scholar
  • 40 Sihvo E I, Luostarinen M E, Salo J A. Fate of patients with adenocarcinoma of the esophagus and the esophagogastric junction: a population-based analysis.  Am J Gastroenterol. 2004;  99 (3) 419-424
    Google Scholar
  • 41 Victorzon van M, Tolonen P, Kohonen M. et al . Outcome of surgery for oesophageal carcinoma in a low volume centre, with and without preoperative chemoradiotherapy.  Scand J Surg. 2004;  93 (1) 37-42
    Google Scholar
  • 42 Van Veldhuyzen Zanten S J, Thomson A B, Barkun A N. et al . The prevalence of Barrett’s oesophagus in a cohort of 1040 Canadian primary care patients with uninvestigated dyspepsia undergoing prompt endoscopy.  Aliment Pharmacol Ther. 2006;  23 (5) 595-599
    Google Scholar
  • 43 Solaymani-Dodaran M, Logan R F, West J. et al . Risk of oesophageal cancer in Barrett’s oesophagus and gastro-oesophageal reflux.  Gut. 2004;  53 (8) 1070-1074
    Google Scholar
  • 44 Solaymani-Dodaran M, Logan R F, West J. et al . Mortality associated with Barrett’s esophagus and gastroesophageal reflux disease diagnoses - a population-based cohort study.  Am J Gastroenterol. 2005;  100 (12) 2616-2621
    Google Scholar
  • 45 Jankowski J A, Provenzale D, Moayyedi P. Esophageal adenocarcinoma arising from Barrett’s metaplasia has regional variations in the west.  Gastroenterology. 2002;  122 (2) 588-590
    Google Scholar
  • 46 Armstrong D. Review article: towards consistency in the endoscopic diagnosis of Barrett’s oesophagus and columnar metaplasia.  Aliment Pharmacol Ther. 2004;  20 Suppl 5 40-47
    Google Scholar
  • 47 Hanna S, Rastogi A, Weston A P. et al . Detection of Barrett’s esophagus after endoscopic healing of erosive esophagitis.  Am J Gastroenterol. 2006;  101 (7) 1416-1420
    Google Scholar
  • 48 Sharma P, Weston A P, Topalovski M. et al . Magnification chromoendoscopy for the detection of intestinal metaplasia and dysplasia in Barrett’s oesophagus.  Gut. 2003;  52 (1) 24-27
    Google Scholar
  • 49 Kiesslich R, Neurath M F, Galle P R. Chromoendoscopy and magnifying endoscopy in patients with gastroesophageal reflux disease. Useful or negligible?.  Dig Dis. 2004;  22 (2) 142-147
    Google Scholar
  • 50 Kiesslich R, Bergh von M, Hahn M. et al . Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon.  Endoscopy. 2001;  33 (12) 1001-1006
    Google Scholar
  • 51 Kiesslich R, Hahn M, Herrmann G. et al . Screening for specialized columnar epithelium with methylene blue: chromoendoscopy in patients with Barrett’s esophagus and a normal control group.  Gastrointest Endosc. 2001;  53 (1) 47-52
    Google Scholar
  • 52 Guelrud M, Herrera I, Essenfeld H. et al . Enhanced magnification endoscopy: a new technique to identify specialized intestinal metaplasia in Barrett’s esophagus.  Gastrointest Endosc. 2001;  53 (6) 559-565
    Google Scholar
  • 53 Guelrud M, Herrera I. Acetic acid improves identification of remnant islands of Barrett’s epithelium after endoscopic therapy.  Gastrointest Endosc. 1998;  47 (6) 512-515
    Google Scholar
  • 54 Endo T, Awakawa T, Takahashi H. et al . Classification of Barrett’s epithelium by magnifying endoscopy.  Gastrointest Endosc. 2002;  55 (6) 641-647
    Google Scholar
  • 55 Ferguson D D, DeVault K R, Krishna M. et al . Enhanced magnification-directed biopsies do not increase the detection of intestinal metaplasia in patients with GERD.  Am J Gastroenterol. 2006;  101 (7) 1611-1616
    Google Scholar
  • 56 Meining A, Rosch T, Kiesslich R. et al . Inter- and intra-observer variability of magnification chromoendoscopy for detecting specialized intestinal metaplasia at the gastroesophageal junction.  Endoscopy. 2004;  36 (2) 160-164
    Google Scholar
  • 57 Dickman R, Bautista J M, Wong W M. et al . Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups.  Am J Gastroenterol. 2006;  101 (11) 2463-2469
    Google Scholar
  • 58 Sharma P, McQuaid K, Dent J. et al . A critical review of the diagnosis and management of Barrett’s esophagus: the AGA Chicago Workshop.  Gastroenterology. 2004;  127 (1) 310-330
    Google Scholar
  • 59 Fountoulakis A, Zafirellis K D, Dolan K. et al . Effect of surveillance of Barrett’s oesophagus on the clinical outcome of oesophageal cancer.  Br J Surg. 2004;  91 (8) 997-1003
    Google Scholar
  • 60 Sandick J W, Lanschot van J J, Kuiken B W. et al . Impact of endoscopic biopsy surveillance of Barrett’s oesophagus on pathological stage and clinical outcome of Barrett’s carcinoma.  Gut. 1998;  43 (2) 216-222
    Google Scholar
  • 61 Eisen G M, Sandler R S, Murray van S. et al . The relationship between gastroesophageal reflux disease and its complications with Barrett’s esophagus.  Am J Gastroenterol. 1997;  92 (1) 27-31
    Google Scholar
  • 62 Dickman R, Kim J L, Camargo L. et al . Correlation of gastroesophageal reflux disease symptoms characteristics with long-segment Barrett’s esophagus.  Dis Esophagus. 2006;  19 (5) 360-365
    Google Scholar
  • 63 Gerson L B, Shetler K, Triadafilopoulos G. Prevalence of Barrett’s esophagus in asymptomatic individuals.  Gastroenterology. 2002;  123 (2) 461-467
    Google Scholar
  • 64 Rex D K, Cummings O W, Shaw M. et al . Screening for Barrett’s esophagus in colonoscopy patients with and without heartburn.  Gastroenterology. 2003;  125 (6) 1670-1677
    Google Scholar
  • 65 Sampliner R E. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. The Practice Parameters Committee of the American College of Gastroenterology.  Am J Gastroenterol. 1998;  93 (7) 1028-1032
    Google Scholar
  • 66 Cameron A J, Carpenter H A. Barrett’s esophagus, high-grade dysplasia, and early adenocarcinoma: a pathological study.  Am J Gastroenterol. 1997;  92 (4) 586-591
    Google Scholar
  • 67 Falk G W, Rice T W, Goldblum J R. et al . Jumbo biopsy forceps protocol still misses unsuspected cancer in Barrett’s esophagus with high-grade dysplasia.  Gastrointest Endosc. 1999;  49 (2) 170-176
    Google Scholar
  • 68 Heitmiller R F. Prophylactic esophagectomy in Barrett esophagus with high-grade dysplasia.  Langenbecks Arch Surg. 2003;  388 (2) 83-87
    Google Scholar
  • 69 Heitmiller R F, Redmond M, Hamilton S R. Barrett’s esophagus with high-grade dysplasia. An indication for prophylactic esophagectomy.  Ann Surg. 1996;  224 (1) 66-71
    Google Scholar
  • 70 Reid B J, Blount P L, Feng Z. et al . Optimizing endoscopic biopsy detection of early cancers in Barrett’s high-grade dysplasia.  Am J Gastroenterol. 2000;  95 (11) 3089-3096
    Google Scholar
  • 71 Buttar N S, Wang K K, Sebo T J. et al . Extent of high-grade dysplasia in Barrett’s esophagus correlates with risk of adenocarcinoma.  Gastroenterology. 2001;  120 (7) 1630-1639
    Google Scholar
  • 72 Rice T W. Pro: esophagectomy is the treatment of choice for high-grade dysplasia in Barrett’s esophagus.  Am J Gastroenterol. 2006;  101 (10) 2177-2179
    Google Scholar
  • 73 Ell C, May A, Gossner L. et al . Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus.  Gastroenterology. 2000;  118 (4) 670-677
    Google Scholar
  • 74 May A, Gossner L, Pech O. et al . Local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barrett’s oesophagus: acute-phase and intermediate results of a new treatment approach.  Eur J Gastroenterol Hepatol. 2002;  14 (10) 1085-1091
    Google Scholar
  • 75 May A, Gossner L, Pech O. et al . Intraepithelial high-grade neoplasia and early adenocarcinoma in short-segment Barrett’s esophagus (SSBE): curative treatment using local endoscopic treatment techniques.  Endoscopy. 2002;  34 (8) 604-610
    Google Scholar
  • 76 Pech O, May A, Gossner L. et al . Curative endoscopic therapy in patients with early esophageal squamous-cell carcinoma or high-grade intraepithelial neoplasia.  Endoscopy. 2007;  39 (1) 30-35
    Google Scholar
  • 77 Ormsby A H, Petras R E, Henricks W H. et al . Observer variation in the diagnosis of superficial oesophageal adenocarcinoma.  Gut. 2002;  51 (5) 671-676
    Google Scholar
  • 78 Schnell T G, Sontag S J, Chejfec G. et al . Long-term nonsurgical management of Barrett’s esophagus with high-grade dysplasia.  Gastroenterology. 2001;  120 (7) 1607-1619
    Google Scholar
  • 79 Vieth M, Stolte M. Barrett’s esophagus and neoplasia: data from the Bayreuth Barrett’s archive.  Gastroenterology. 2002;  122 (2) 590-591
    Google Scholar
  • 80 Seewald S, Akaraviputh T, Seitz U. et al . Circumferential EMR and complete removal of Barrett’s epithelium: a new approach to management of Barrett’s esophagus containing high-grade intraepithelial neoplasia and intramucosal carcinoma.  Gastrointest Endosc. 2003;  57 (7) 854-859
    Google Scholar
  • 81 May A, Gossner L, Behrens A. et al . A prospective randomized trial of two different endoscopic resection techniques for early stage cancer of the esophagus.  Gastrointest Endosc. 2003;  58 (2) 167-175
    Google Scholar
  • 82 Kakushima N, Fujishiro M, Kodashima S. et al . A learning curve for endoscopic submucosal dissection of gastric epithelial neoplasms.  Endoscopy. 2006;  38 (10) 991-995
    Google Scholar
  • 83 Rosch T, Sarbia M, Schumacher B. et al . Attempted endoscopic en bloc resection of mucosal and submucosal tumors using insulated-tip knives: a pilot series.  Endoscopy. 2004;  36 (9) 788-801
    Google Scholar
  • 84 Peters F P, Kara M A, Rosmolen W D. et al . Stepwise radical endoscopic resection is effective for complete removal of Barrett’s esophagus with early neoplasia: a prospective study.  Am J Gastroenterol. 2006;  101 (7) 1449-1457
    Google Scholar
  • 85 Schlemper R J, Hirata I, Dixon M F. The macroscopic classification of early neoplasia of the digestive tract.  Endoscopy. 2002;  34 (2) 163-168
    Google Scholar
  • 86 Pech O, May A, Gunter E. et al . The impact of endoscopic ultrasound and computed tomography on the TNM staging of early cancer in Barrett’s esophagus.  Am J Gastroenterol. 2006;  101 (10) 2223-2229
    Google Scholar
  • 87 Holscher A H, Bollschweiler E, Schneider P M. et al . Early adenocarcinoma in Barrett’s oesophagus.  Br J Surg. 1997;  84 (10) 1470-1473
    Google Scholar
  • 88 Stein H J, Feith M, Mueller J. et al . Limited resection for early adenocarcinoma in Barrett’s esophagus.  Ann Surg. 2000;  232 (6) 733-742
    Google Scholar
  • 89 Rice T W, Zuccaro G Jr, Adelstein D J. et al . Esophageal carcinoma: depth of tumor invasion is predictive of regional lymph node status.  Ann Thorac Surg. 1998;  65 (3) 787-792
    Google Scholar
  • 90 Ruol A, Merigliano S, Baldan N. et al . Prevalence, management and outcome of early adenocarcinoma (pT1) of the esophago-gastric junction. Comparison between early cancer in Barrett’s esophagus (type I) and early cancer of the cardia (type II).  Dis Esophagus. 1997;  10 (3) 190-195
    Google Scholar
  • 91 van Sandick J W, van Lanschot J J, ten Kate F J. et al . Pathology of early invasive adenocarcinoma of the esophagus or esophagogastric junction: implications for therapeutic decision making.  Cancer. 2000;  88 (11) 2429-2437
    Google Scholar
  • 92 Bollschweiler E, Baldus S E, Schroder W. et al . High rate of lymph-node metastasis in submucosal esophageal squamous-cell carcinomas and adenocarcinomas.  Endoscopy. 2006;  38 (2) 149-156
    Google Scholar
  • 93 Vieth M, Rosch T. Endoscopic mucosal resection and the risk of lymph-node metastases: indications revisited?.  Endoscopy. 2006;  38 (2) 175-179
    Google Scholar
  • 94 Guidelines for the clinical and pathological studies of carcinoma of the esophagus. March 1992 (8th edition): Japanese society of esophageal diseases. Tokyo; Kanehara and Co 2003
    Google Scholar
  • 95 Ell C, May A, Pech O. et al . Curative endoscopic resection of early esophageal adenocarcinomas (Barrett’s cancer).  Gastrointest Endosc. 2007;  65 (1) 3-10
    Google Scholar
  • 96 Pech O, Gossner L, May A. et al . Long-term results of photodynamic therapy with 5-aminolevulinic acid for superficial Barrett’s cancer and high-grade intraepithelial neoplasia.  Gastrointest Endosc. 2005;  62 (1) 24-30
    Google Scholar
  • 97 Avidan B, Sonnenberg A, Schnell T G. et al . Hiatal hernia size, Barrett’s length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma.  Am J Gastroenterol. 2002;  97 (8) 1930-1936
    Google Scholar
  • 98 Avidan B, Sonnenberg A, Schnell T G. et al . Hiatal hernia and acid reflux frequency predict presence and length of Barrett’s esophagus.  Dig Dis Sci. 2002;  47 (2) 256-264
    Google Scholar
  • 99 Inomata Y, Koike T, Ohara S. et al . Preservation of gastric acid secretion may be important for the development of gastroesophageal junction adenocarcinoma in Japanese people, irrespective of the H. pylori infection status.  Am J Gastroenterol. 2006;  101 (5) 926-933
    Google Scholar
  • 100 Cooper B T, Chapman W, Neumann C S. et al . Continuous treatment of Barrett’s oesophagus patients with proton pump inhibitors up to 13 years: observations on regression and cancer incidence.  Aliment Pharmacol Ther. 2006;  23 (6) 727-733
    Google Scholar
  • 101 Hillman L C, Chiragakis L, Shadbolt B. et al . Proton-pump inhibitor therapy and the development of dysplasia in patients with Barrett’s oesophagus.  Med J Aust. 2004;  180 (8) 387-391
    Google Scholar
  • 102 El Serag H B, Aguirre T, Kuebeler M. et al . The length of newly diagnosed Barrett’s oesophagus and prior use of acid suppressive therapy.  Aliment Pharmacol Ther. 2004;  19 (12) 1255-1260
    Google Scholar
  • 103 Jankowski J A, Perry I, Harrison R F. Gastro-oesophageal cancer: death at the junction.  BMJ. 2000;  321 (7259) 463-464
    Google Scholar
  • 104 El Serag H B, Aguirre T V, Davis S. et al . Proton pump inhibitors are associated with reduced incidence of dysplasia in Barrett’s esophagus.  Am J Gastroenterol. 2004;  99 (10) 1877-1883
    Google Scholar
  • 105 Malfertheiner P, Lind T, Willich S. et al . Prognostic influence of Barrett’s oesophagus and Helicobacter pylori infection on healing of erosive gastro-oesophageal reflux disease (GORD) and symptom resolution in non-erosive GORD: report from the ProGORD study.  Gut. 2005;  54 (6) 746-751
    Google Scholar
  • 106 Ouatu-Lascar R, Fitzgerald R C, Triadafilopoulos G. Differentiation and proliferation in Barrett’s esophagus and the effects of acid suppression.  Gastroenterology. 1999;  117 (2) 327-335
    Google Scholar
  • 107 Peters F T, Ganesh S, Kuipers E J. et al . Endoscopic regression of Barrett’s oesophagus during omeprazole treatment; a randomised double blind study.  Gut. 1999;  45 (4) 489-494
    Google Scholar
  • 108 Fitzgerald R C, Omary M B, Triadafilopoulos G. Dynamic effects of acid on Barrett’s esophagus. An ex vivo proliferation and differentiation model.  J Clin Invest. 1996;  98 (9) 2120-2128
    Google Scholar
  • 109 Feagins L A, Zhang H Y, Hormi-Carver K. et al . Acid has antiproliferative effects in nonneoplastic Barrett’s epithelial cells.  Am J Gastroenterol. 2007;  102 (1) 10-20
    Google Scholar
  • 110 Souza R F, Shewmake K, Terada L S. et al . Acid exposure activates the mitogen-activated protein kinase pathways in Barrett’s esophagus.  Gastroenterology. 2002;  122 (2) 299-307
    Google Scholar
  • 111 Umansky M, Yasui W, Hallak A. et al . Proton pump inhibitors reduce cell cycle abnormalities in Barrett’s esophagus.  Oncogene. 2001;  20 (55) 7987-7991
    Google Scholar
  • 112 Anderson L A, Johnston B T, Watson R G. et al . Nonsteroidal anti-inflammatory drugs and the esophageal inflammation-metaplasia-adenocarcinoma sequence.  Cancer Res. 2006;  66 (9) 4975-4982
    Google Scholar
  • 113 Corley D A, Kerlikowske K, Verma R. et al . Protective association of aspirin/NSAIDs and esophageal cancer: a systematic review and meta-analysis.  Gastroenterology. 2003;  124 (1) 47-56
    Google Scholar
  • 114 Farrow D C, Vaughan T L, Hansten P D. et al . Use of aspirin and other nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer.  Cancer Epidemiol Biomarkers Prev. 1998;  7 (2) 97-102
    Google Scholar
  • 115 Funkhouser E M, Sharp G B. Aspirin and reduced risk of esophageal carcinoma.  Cancer. 1995;  76 (7) 1116-1119
    Google Scholar
  • 116 Gammon M D, Terry M B, Arber N. et al . Nonsteroidal anti-inflammatory drug use associated with reduced incidence of adenocarcinomas of the esophagus and gastric cardia that overexpress cyclin D 1: a population-based study.  Cancer Epidemiol Biomarkers Prev. 2004;  13 (1) 34-39
    Google Scholar
  • 117 Heath E I, Canto M I, Piantadosi S. et al . Secondary chemoprevention of Barrett’s esophagus with celecoxib: results of a randomized trial.  J Natl Cancer Inst. 2007;  99 (7) 545-557
    Google Scholar
  • 118 Jankowski J, Barr H. Improving surveillance for Barrett’s oesophagus: AspECT and BOSS trials provide an evidence base.  BMJ. 2006;  332 (7556) 1512
    Google Scholar
  • 119 Corley D A, Levin T R, Habel L A. et al . Barrett’s esophagus and medications that relax the lower esophageal sphincter.  Am J Gastroenterol. 2006;  101 (5) 937-944
    Google Scholar
  • 120 Lagergren J, Bergstrom R, Adami H O. et al . Association between medications that relax the lower esophageal sphincter and risk for esophageal adenocarcinoma.  Ann Intern Med. 2000;  133 (3) 165-175
    Google Scholar
  • 121 Vaughan T L, Farrow D C, Hansten P D. et al . Risk of esophageal and gastric adenocarcinomas in relation to use of calcium channel blockers, asthma drugs, and other medications that promote gastroesophageal reflux.  Cancer Epidemiol Biomarkers Prev. 1998;  7 (9) 749-756
    Google Scholar
  • 122 Gutschow C A, Schroder W, Prenzel K. et al . Impact of antireflux surgery on Barrett’s esophagus.  Langenbecks Arch Surg. 2002;  387 (3 - 4) 138-145
    Google Scholar
  • 123 Hofstetter W L, Peters J H, DeMeester T R. et al . Long-term outcome of antireflux surgery in patients with Barrett’s esophagus.  Ann Surg. 2001;  234 (4) 532-538
    Google Scholar
  • 124 Ye W, Chow W H, Lagergren J. et al . Risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux diseases and after antireflux surgery.  Gastroenterology. 2001;  121 (6) 1286-1293
    Google Scholar
  • 125 Spechler S J, Lee E, Ahnen D. et al . Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial.  JAMA. 2001;  285 (18) 2331-2338
    Google Scholar
  • 126 Lundell L, Miettinen P, Myrvold H E. et al . Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease.  J Am Coll Surg. 2001;  192 (2) 172-179
    Google Scholar
  • 127 Parrilla P, Martinez de Haro L F, Ortiz A. et al . Long-term results of a randomized prospective study comparing medical and surgical treatment of Barrett’s esophagus.  Ann Surg. 2003;  237 (3) 291-298
    Google Scholar

Dr. Ulrich Peitz

Klinik für Gastroenterologie, Hepatologie und Infektiologie, Otto-von-Guericke-Universität

Leipziger Str. 44

39120 Magdeburg

Phone: ++ 49/3 91/6 71 31 25

Fax: ++ 49/3 91/6 71 31 05

Email: ulrich.peitz@medizin.uni-magdeburg.de

      >