Barrett's esophagus and esophageal cancer: An overview

Conteduca,Vincenza; Sansonno,Domenico; Ingravallo,Giuseppe; Marangi,Stefania; Russi,Sabino; Lauletta,Gianfranco; Dammacco,Franco

doi:10.3892/ijo.2012.1481

Barrett's esophagus and esophageal cancer: An overview

Authors:
- Vincenza Conteduca
- Domenico Sansonno
- Giuseppe Ingravallo
- Stefania Marangi
- Sabino Russi
- Gianfranco Lauletta
- Franco Dammacco
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Affiliations: Department of Internal Medicine and Clinical Oncology, University of Bari Medical School, Bari, Italy, Department of Pathology, University of Bari Medical School, Bari, Italy, Digestive Endoscopy Unit, Department of Oncology, John Paul II Center for High Technology Research and Education in Biomedical Sciences, Campobasso, Italy
Published online on: May 17, 2012 https://doi.org/10.3892/ijo.2012.1481
Pages: 414-424

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Abstract

Although esophageal cancer (EC) is the eighth most common cancer in several European countries, it is one of deadliest worldwide. The most frequent predisposing factor implicated in its development is Barrett's esophagus (BE), an acquired metaplastic transformation of the esophageal lining cells from normal squamous epithelium into specialised or intestinal-like columnar epithelium. The major risk factor for BE is gastroesophageal reflux disease. Although BE is in itself a benign and often asymptomatic disorder, its clinical importance stems from the recognition that it represents the main precursor lesion for the development of esophageal adenocarcinoma (AC), a tumor that is rapidly increasing especially in developed countries and is associated with a low survival rate. This paper provides an overview of the epidemiology and natural history of BE as well as of the possible pathogenetic mechanisms underlying the development of BE and its progressive transition to AC. New diagnostic tests are described, recommendations for screening and surveillance are provided and surgical and ablative procedures to treat dysplastic lesions and early neoplasia are discussed. Claimed chemopreventive agents and biomarkers that in the near future may help identify people with a higher risk of EC are also considered.

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