Endotherapy for Barrett's esophagus with high-grade dysplasia and intramucosal carcinoma.

摘要

The incidence of adenocarcinoma of the esophagus in the USA appears to be rising rapidly.1'2 The prevalence of Barrett's esophagus (BE) appears to be increasing as well.3 The vast majority of adenocarcinoma of the esophagus arises within Barrett's esophagus, and the identification of the immediate histologic precursor to cancer, high-grade dysplasia (HGD), is the endpoint of current Barrett's surveillance programs.4 Once HGD has been found, management has included close endoscopic surveillance, esophagectomy, and, more recently, endoscopic ablative therapies (ET). ET has included photodynamic therapy (PDT), endoscopic mucosal resection (EMR), endoscopic submucosal dissection, radiofrequency ablation (RFA) and cryotherapy, as well as a variety of thermal treatments such as argon plasma coagulation (APC).