Barrett's esophagus: prevalence and incidence of adenocarcinomas
The following on prevalence and incidence of adenocarcinomas in Barrett's esphophagus (BE) includes commentaries on the mechanisms of a potential protective effect of proton pump inhibitors (PPIs) on progression of BE to high-grade dysplasia; evaluation of the role of PPIs in decreasing the risk of degeneration; the geographical variations of incidence of BE; the role of the nonmorphologic biomarkers; the relationship between length of BE and development of cancer; the confounding factors in incidence rates of BE; the role of the increase of cell differentiation and apoptosis induced by PPIs in the diminution of cancer risk; the frequency of occult neoplastic foci and unsuspected invasive cancer in surgical specimens; the influence on the indications of endoscopic therapy; the overestimation of regression in surgical series; attempts to evaluate the reasons for variations of cancer incidence in the literature; and progress in screening and surveillance for BE.
barrett's esophagus adenocarcinoma high-grade dysplasia barrett's epithelium proton pump inhibitor therapy low-grade dysplasia oxidative stress cytokines helicobacter pylori adipocytokines esophageal cancer cyclooxygenase occult neoplasia submucosal invasion endoscopic treatment esophagectomy intramucosal carcinoma short-segment and long-segment barrett's esophagus metaplasia antireflux surgery