BARRETT’S ESOPHAGUS: CONTEMPORARY DIAGNOSTIC AND THERAPEUTIC APPROACHES
Abstract
The article represents the first experience of endoscopic mucosal cap resection of Barrett’s epithelium in Belarus. The implementation of endoscopic treatment of intestinal metaplasia into clinical practice is suggested on the basis of a case report and literature data. The comparison has been drawn between the updated clinical guidelines on the diagnosis and management of Barrett’s esophagus of different gastroenterological societies. It should be noted however that this article covers the aspect of endoscopic surveillance and treatment of esophageal columnar epithelium only. It doesn’t focus on a combination therapy that should include drug therapy of gastroesophageal reflux disease (GERD) and surgery of the lower esophageal sphincter incompetence if need be.References
1. Spechler SJ, Souza RF. Barrett’s esophagus. N. Engl. J. Med. 2014;371(9):836-845. doi: 10.1056/NEJMra1314704.
2. Pohl H, Welch HG. The role of overdiagnosis and reclassification in the marked increase of esophageal adenocarcinoma incidence. J. Natl. Cancer Inst. 2005;97(2):142-146. doi: 10.1093/jnci/dji024.
3. Rajendra S, Sharma P. Management of Barrett’s oesophagus and intramucosal oesophageal cancer: a review of recent development. Therap. Adv. Gastroenterol. 2012;5(5):285-299. doi:10.1177/1756283X12446668.
4. Malkevich VT. Jepidemiologija raka pishhevoda v Respublike Belarus [Epidemiology of Esophageal cancer in Belarus]. Onkologicheskij zhurnal [Oncological journal]. 2009;3(4):75-84. (Russian).
5. Ivashkin VT, Maev IV, Truhmanov AS. Pishhevod Barreta [Barrett’s esophagus]. Sevastopol: Shiko; 2011. 608 p. (Russian).
6. Ministerstvo Zdravoohranienija Respubliki Belarus. Klinicheskij protokol „Diagnostika i lechenie pacientov s zabolevanijami organov pishhevarenija.” Postanovlenie № 90 (ijul 21, 2016) [Clinical protocol “Diagnosis and treatment of patients with diseases of the digestive system”]. [Internet]. Available from: http://med.by/normativ/ptmz/2016/ptmz90. pdf. (Belarusian).
7. Fitzgerald RC, di Pietro M, Ragunath K, Ang Y, Kang JY, Watson P, Trudgill N, Patel P, Kaye PV, Sanders S, O’Donovan M, Bird-Lieberman E, Bhandari P, Jankowski JA, Attwood S, Parsons SL, Loft D, Lagergren J, Moayyedi P, Lyratzopoulos G, de Caestecker J. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63(1):7-42. doi: 10.1136/gutjnl-2013-305372.
8. Weusten B, Bisschops R, Coron E, Dinis-Ribeiro M, Dumonceau JM, Esteban JM, Hassan C, Pech O, Repici A, Bergman J, di Pietro M. Endoscopic management of Barrett’s esophagus: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy. 2017;49(2):191-198. doi: 10.1055/s-0042-122140.
9. Shaheen NJ, Falk GW, Iyer PG, Gerson LB; American College of Gastroenterology. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. Am. J. Gastroenterol. 2016;111(1):30-50. doi: 10.1038/ajg.2015.322.
10. Ivashkin VT, Maev IV, Truhmanov AS, Sokolov VV, Pirogov SS, Zajratjanc OV, Sheptulin AA, Lapina TL, Zajratjanc GO, Kajbysheva VO. Pishhevod Barreta [Barrett’s esophagus]. Moskva; 2014. 31 p. (Russian).
11. Spechler SJ, Goyal RK. The columnar lined esophagus, intestinal metaplasia, and Norman Barrett. Gastroenterology. 1996;110(2):614-621.
12. Theisen J, Nigro JJ, DeMeester TR, Peters JH, Gastal OL, Hagen JA, Hashemi M, Bremner CG. Chronology of the Barrett’s metaplasia-dysplasia-carcinoma sequence. Dis. Esophagus. 2004;17(1):67-70. doi: 10.1111/j.1442-2050.2004.00376.x.
13. Pirogov SS, Kuvshinov JuP, Stilidi IS, Poddubnyj BK, Ivashkin VT, Malihova OA, Truhmanov AS, Zaharova TI, Chistjakova OV. Novyj vzgljad na problemu pishhevoda Barretta [New viewpoint on a Barret’s esophagus problem]. Rossijskij zhurnal gastrojenterologii, gepatologii, koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2008;18(3):25-34. (Russian).
14. Desai TK, Krishnan K, Samala N, Singh J, Cluley J, Perla S, Howden CW. The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett’s oesophagus: a meta-analysis. Gut. 2012;61(7):970-976. doi: 10.1136/gutjnl-2011-300730.
15. Kardasheva SS, Truhmanov AS, Demura TA, Konkov MJu, Skljanskaja OA, Kogan EA, Ivashkin VT. Klinicheskaja kartina, faktory riska i immunogistohimicheskie marker pri pishhevode Barretta [Clinical pattern, risk factors and immunohistochemical markers at Barret’s esophagus]. Rossijskij zhurnal Gastrojenterologii, Gepatologii, Koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2008;18(3):15-25. (Russian).
16. Moole H, Patel J, Ahmed Z, Duvvuri A, Vennelaganti S, Moole V, Dharmapuri S, Boddireddy R, Yedama P, Bondalapati N, Uppu A, Vennelaganti P, Puli S. Progression from low-grade dysplasia to malignancy in patients with Barrett’s esophagus diagnosed by two or more pathologists. World J. Gastroenterol. 2016;22(39):8831-8843. doi: 10.3748/wjg.v22.i39.8831.
17. Zajratjanc OV, Kononov AV. Patologicheskaja anatomija pishhevoda Barretta [The pathological anatomy of Barrett’s esophagus]. Moskva; 2016. 21 p. (Russian).
18. Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, Dixon MF, Fenoglio-Preiser CM, Fléjou JF, Geboes K, Hattori T, Hirota T, Itabashi M, Iwafuchi M, Iwashita A, Kim YI, Kirchner T, Klimpfinger M, Koike M, Lauwers GY, Lewin KJ, Oberhuber G, Offner F, Price AB, Rubio CA, et al. The Vienna classification of gastrointestinal epithelial neoplasia. Gut. 2000;47(2):251-255.
19. Peters FP, Brakenhoff KP, Curvers WL, Rosmolen WD, Fockens P, ten Kate FJ, Krishnadath KK, Bergman JJ. Histologic evaluation of resection specimens obtained at 293 endoscopic resections in Barrett’s esophagus. Gastrointest. Endosc. 2008;67(4):604-609. doi: 10.1016/j.gie.2007.08.039.
20. Anandasabapathy S1, Jhamb J, Davila M, Wei C, Morris J, Bresalier R. Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia. Cancer. 2007;109(4):668-674. doi: 10.1002/cncr.22451.
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