New viewpoint on a Barrett’s esophagus problem
Abstract
Aim of investigation. To specify concept of Barrett’s esophagus (BE) from oncology viewpoint and to estimate its relation to some complications of gastroesophageal reflux disease (GERD)
Stuff and methods. Article presents comparative data of endoscopic and morphological investigations for 168 patients with suspicion for BE. The protocol of endoscopy included application on mucosa of esophagus of 1,5% acetic acid solution, chromoesophagoscopy with Lugol’s iodine solution and methylene dark blue, inspection in NBI regimen with magnification, and combined procedures.
Results. Of 168 patients incomplete intestinal metaplasia (IM) of squamous epithelium proximal from cardioesophageal transition was revealed only in 21,4%. Other types of epithelium were found at esophagus in rest: complete IM of squamous epithelium, IM of cardial or fundal epithelium, gastric types of epithelium without IM. The majority (36,8%) of so-called «ultrashort BE» cases were presented by IM of cardia epithelium. Various stages of BE neoplastic transformation (mild, moderate and severe dysplasia, adenocarcinoma) were most frequently revealed on the background of IM of squamous epithelium. Cumulative frequency of GERD complications, such as ulcers, erosions and scars of esophagus at IM of squamous epithelium, was 42,1% that does not allow to assume clear association of BE and these forms of reflux disorders of esophagus.
Conclusions. BE as a facultative premalignant state should include only the cases of incomplete IM of squamous epithelium of esophagus. No direct link of BE and of its stages of neoplastic transformation with other complications of GERD was revealed in the study.
About the Authors
S. S. PirogovRussian Federation
Yu. P. Kuvshinov
Russian Federation
I. S. Stilidi
Russian Federation
B. K. Poddubny
Russian Federation
V. Т. Ivashkin
Russian Federation
O. A. Malikhova
Russian Federation
A. S. Trukhmanov
Russian Federation
T. I. Zakharova
Russian Federation
О. V. Chistyakova
Russian Federation
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Review
For citations:
Pirogov S.S., Kuvshinov Yu.P., Stilidi I.S., Poddubny B.K., Ivashkin V.Т., Malikhova O.A., Trukhmanov A.S., Zakharova T.I., Chistyakova О.V. New viewpoint on a Barrett’s esophagus problem. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2008;18(3):25-33. (In Russ.)
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