Korean J Helicobacter Up Gastrointest Res.  2012 Jun;12(2):67-70. 10.7704/kjhugr.2012.12.2.67.

Natural History and Follow-up Strategy of Barrett's Esophagus

Affiliations
  • 1Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea. kimss@catholic.ac.kr

Abstract

Barrett's esophagus is defined as intestinal metaplasia in columnar mucosa of the esophagus from endoscopic mucosal biopsy. Barrett's esophagus is a complication of gastroesophageal reflux disease and is the leading cause of esophageal adenocarcinoma. According to recent data, the annual incidence of low grade dysplasia, high grade dysplasia, and adenocarcinoma in patients with Barrett's esophagus were 3.6%, 0.48%, and 0.27%, respectively. Annual incidence of esophageal adenocarcinoma in patients with low grade dysplasia is 0.6%, and that in high grade dysplasia is 5.6%. Endoscopic surveillance of Barrett's esophagus should be performed with the purpose of detecting dysplasia and adenocarcinoma. Endos-copic surveillance of Barrett's esophagus is recommended at an interval of 2~5 years, and if low grade dysplasia develops, then follow up endoscopy should be done at 2 months to 1 year interval. If high grade dysplasia is detected, then it should be resected endoscopically. Biopsy for detection of Barrett's esophagus is recommended as a random four quadrant biopsy of 2 cm intervals in the columnar metaplasia. However, due to the relatively low incidence of esophageal adenocarcinoma, low cost of endoscopic examination, and frequent endoscopic examination due to country-based gastric cancer surveillance program in our country, the foreign guideline of Barrett's esophagus should be adjusted to our circumstance.

Keyword

Barrett's esophagus; Dysplasia; Adenocarcinoma; Surveillance
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