Barrett's esophagus and Barrett's-associated neoplasia: Etiology and pathologic features

Abstract

Background: The incidence of Barrett's esophagus (BE) has been increasing in recent years. Patients with BE have 30- to 125-fold increased risk of developing adenocarcinoma. New techniques allowing early diagnosis, in addition to the identification of markers capable of predicting tumor progression, are needed. Methods: The authors discuss the diagnostic features of BE and BE-associated neoplasia. Results: BE can exhibit different types of metaplastic mucosa, but only the specialized (intestinal) mucosa has the potential to progress to dysplasia and carcinoma. The problems associated with diagnosing BE and with predicting the behavior of this condition are outlined. Conclusions: Studies are underway to identify molecular markers capable of predicting which BE patient will progress to carcinoma. Brush cytology and flow cytometry may become useful tools in the early detection of this disease.