Barrett’s Esophagus: Emerging Evidence for Improved Clinical by Douglas Pleskow MD

By Douglas Pleskow MD

Barrett’s Esophagus: rising proof for greater medical Practice

is a finished reference at the therapy and new imaging modalities of Barrett’s Esophagus for researchers, clinicians, and students. each one bankruptcy consists from the point of view of investigators who summarize the information in addition to the reasoning at the back of why these reports have been conceived.

In addition, the long run instructions of study are mentioned inside each one bankruptcy, supplying insights from the investigators. study questions are defined, and state-of-the-art purposes are defined. each one bankruptcy comprises medical situations to spotlight the instructions within which the study is, and may be, heading.

  • Provides a standpoint into the study at the back of Barrett’s Esophagus
  • Emphasizes the rising applied sciences in surveillance and therapy of Barrett’s
  • Features medical eventualities to focus on the instructions within which study is, and will be, heading
  • Includes insurance of present directions and discussions on the place those instructions fall short

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Additional info for Barrett’s Esophagus: Emerging Evidence for Improved Clinical Practice

Sample text

Jones DR, Davidson AG, Summers CL, Murray GF, Quinlan DC. Potential application of p53 as an intermediate biomarker in Barrett’s esophagus. Ann Thorac Surg 1994;57:598À603. 35 [61] Ramel S, Reid BJ, Sanchez CA, et al. Evaluation of p53 protein expression in Barrett’s esophagus by twoparameter flow cytometry. Gastroenterology 1992;102:1220À8. [62] Hamelin R, Flejou JF, Muzeau F, et al. TP53 gene mutations and p53 protein immunoreactivity in malignant and premalignant Barrett’s esophagus. Gastroenterology 1994;107:1012À18.

The ideal marker would be detectable early in the metaplasiaÀdysplasiaÀcarcinoma sequence, even before there is morphologic evidence of dysplasia, and capable of distinguishing progressors from nonprogressors. Numerous studies have evaluated p53 expression by immunohistochemistry, most of which attempt to correlate the degree of p53 expression with the grade of dysplasia or solely as a marker of increased risk of progressing to adenocarcinoma. p53 overexpression has been observed in 9À60% of cases with lowgrade dysplasia and 55À100% of cases with high-grade dysplasia [58À61].

Histologic evaluation of dysplasia in endoscopic biopsy samples remains the main method of risk assessment in patients with BE. Epithelial dysplasia, particularly high-grade dysplasia, is considered to be one of the most important risk factors for both synchronous 27 and metachronous esophageal adenocarcinoma [41À43]. Therefore, its identification is an integral part of cancer screening and surveillance programs as well as a trigger point for therapeutic intervention. Dysplasia is defined as neoplastic change of the epithelium that remains confined within the basement membrane of the gland from which it arises (ie, intraepithelial neoplasia) [44].

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