Zusammenfassung
Die histopathologische Diagnostik der intraepithelialen Neoplasie (früher „Dysplasie”) ist derzeit der Goldstandard für die Risikoabschätzung von Patienten mit einem Barrett-Ösophagus. Molekularbiologische und immunhistochemische Untersuchungen am Barrett-Ösophagus, die in der vorliegenden Übersichtsarbeit diskutiert werden, haben einen wesentlichen Beitrag zum Verständnis der Karzinogenese des Barrett-Karzinoms erbracht. Die Bedeutung neuer molekularbiologischer und immunhistochemischer Marker besteht darin, dass sie objektive ergänzende Informationen für solche diagnostisch und klinisch relevante Fragen bieten könnten, bei denen die Morphologie allein an ihren Grenzen angelangt ist. Dazu stehen derzeit jedoch nur wenige biomolekulare Marker zur Verfügung, die bislang nur in Einzelfällen hilfreich sind.
Abstract
The diagnosis of Barrett’s esophagus and the different degrees of intraepithelial neoplasia appear to be demanding in several aspects. Current data on genetic alterations involved in the carcinogenesis of Barrett’s esophagus are discussed. Several new biomarkers are being tested to help better to determine the risk of cancer development. However, a few immunohistochemical markers have emerged which could be helpful for the differential diagnosis of low- and high-grade intraepithelial neoplasia. Markers which could predict the progression of premalignant Barrett’s epithelium to carcinoma are still to be established. At present, the “goldstandard” for classifying the malignant potential in Barrett’s esophagus is the degree of intraepithelial neoplasia found on standard biopsy protocols.
Schlüsselwörter
Barrett-Ösophagus - intraepitheliale Neoplasie - Barrett- Karzinom - Molekularbiologie
Key words
Barrett’s esophagus - intraepithelial neoplasia - risk of cancer - molecularbiology
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Dr. med. Axel Walch
Pathologisches Institut
Ludwig- Aschoff-Haus
Albertstraße 19
79002 Freiburg
Phone: 07 61/2 03-67 37
Fax: 07 61/2 03-67 90
Email: walch@ukl.uni-freiburg.de
