Barrett-Karzinom - Diagnose, Screening, Surveillance, endoskopische Therapie, Prävention

Zusammenfassung

Das Adenokarzinom des unteren Ösophagus kann auch als Barrett-Karzinom bezeichnet werden, da es sich aus einem Barrett-Ösophagus entwickelt. Der Barrett-Ösophagus als Präneoplasie wird aktuell definiert als endoskopisch sichtbare Zylinderepithelmetaplasie im unteren Ösophagus, in der sich histologisch eine intestinale Metaplasie nachweisen lässt. Eine andere histologische Form der Zylinderepithelmetaplasie im unteren Ösophagus ist kardiatypische Mukosa, die vermutlich der intestinalen Metaplasie vorausgeht, aber keine Becherzellen wie diese enthält. Die Konversionsrate vom Barrett-Ösophagus zum Barrett-Karzinom beträgt 0,5 bis1 % pro Jahr. Patienten mit Refluxbeschwerden sollten frühzeitig endoskopiert werden, um einen Barrett-Ösophagus zu suchen (Screening). Die Identifizierung eines Barrett-Ösophagus hat dann regelmäßige endoskopische Kontrollen zur Folge, deren Intervalle durch Leitlinien festgelegt sind (Surveillance). Ziel ist die Früherkennung einer Neoplasie. Auf das Epithel oder die Mukosa beschränkte Neoplasien können meist endoskopisch reseziert werden. Die histologisch am Resektat bestimmte Infiltrationstiefe erlaubt eine Abschätzung des Lymphknotenmetastasierungsrisikos und ist somit essenziell zur abschließenden Beurteilung, ob der endoskopische Eingriff als kurativ angesehen werden kann. Das Metastasierungsrisiko ist individuell gegenüber dem Morbiditäts- und Mortalitätsrisiko bei einer chirurgischen Resektion abzuwägen. Die rasche Zunahme der Inzidenz des Barrett-Karzinoms in westlichen Ländern deutet auf Lebensstil-Faktoren, insbesondere Übergewicht, als Ursache hin. Daten aus Interventionsstudien zur Prävention stehen jedoch noch aus.

Abstract

An adenocarcinoma of the distal esophagus may also be designated as Barrett’s carcinoma as it evolves from Barrett’s esophagus. Barrett’s esophagus currently is defined as a columnar metaplasia of the distal esophagus, as identified by endoscopy, that, upon histopathology, is confirmed to contain intestinal metaplasia. A different histological entity of columnar metaplasia of the distal esophagus is cardia-type mucosa which probably preceeds intestinal metaplasia, but lacks goblet cells typical for the latter. The conversion rate from Barrett’s esophagus to Barrett’s carcinoma amounts to 0.5 to 1 % per year. Patients with reflux symptoms should undergo early endoscopy in order to search for Barrett’s esophagus (screening). In those cases where Barrett’s esophagus is identified, regular endoscopic controls should be scheduled (surveillance). The intervals for this have been defined by recent consented guidelines. The aim is to detect neoplasia early. Neoplasia confined to the epithelium or mucosal layer can mostly be treated by endoscopic resection. The depth of infiltration, as determined by histolopathology of the resected specimen, allows one to estimate the risk of lymph node metastasis, and therefore is crucial for the final judgment as to whether the endoscopic intervention may be considered curative. Individually, the risk of metastasis has to be weighed against the risk of morbidity and mortality conferred by the alternative surgical resection. The rapid increase of the incidence of Barrett’s carcinoma in Western countries suggests that life style factors, in particular overweight, having a causal role. Data from interventional trials on prevention are, however, pending.

Adenokarzinom - Barrett-Ösophagus - Screening - Surveillance - endoskopische Resektion

adenocarcinoma - Barrett’s esophagus - screening - surveillance - endoscopic resection

Literatur

• 1 Schlansky B, Dimarino A J Jr, Loren D. et al . A survey of oesophageal cancer: pathology, stage and clinical presentation.  Aliment Pharmacol Ther. 2006;  23 (5) 587-593
• 2 Barret N R. Chronic peptic ulcer of the oesophagus and ‘oesophagitis’.  Br J Surg. 1950;  38 (150) 175-182
• 3 Sampliner R E. Updated guidelines for the diagnosis, surveillance, and therapy of Barrett’s esophagus.  Am J Gastroenterol. 2002;  97 (8) 1888-1895
• 4 Koop H, Schepp W, Muller-Lissner S. et al . Consensus conference of the DGVS on gastroesophageal reflux.  Z Gastroenterol. 2005;  43 (2) 163-164
• 5 Messmann H, Ell C, Fein M. et al . Topic Complex VI: Barrett esophagus.  Z Gastroenterol. 2005;  43 (2) 184-190
• 6 Watson A, Heading R C, Shepherd N A. Guidelines for the diagnosis and management of Barrett’s columnar-lined oesophagus.  2005;  , http://www.bsg.org.uk
• 7 Boyer J, Robaszkiewicz M. Guidelines of the French Society of Digestive Endoscopy: monitoring of Barrett’s esophagus. The Council of the French Society of Digestive Endoscopy.  Endoscopy. 2000;  32 (6) 498-499
• 8 Chandrasoma P T, Der R, Ma Y. et al . Histologic classification of patients based on mapping biopsies of the gastroesophageal junction.  Am J Surg Pathol. 2003;  27 (7) 929-936
• 9 Chandrasoma P. Controversies of the cardiac mucosa and Barrett’s oesophagus.  Histopathology. 2005;  46 (4) 361-373
• 10 Peitz U, Vieth M, Pross M. et al . Cardia-type metaplasia arising in the remnant esophagus after cardia resection.  Gastrointest Endosc. 2004;  59 (7) 810-817
• 11 Shaheen N J, Crosby M A, Bozymski E M. et al . Is there publication bias in the reporting of cancer risk in Barrett’s esophagus?.  Gastroenterology. 2000;  119 (2) 333-338
• 12 Lassen A, Hallas J, Muckadell O B. Esophagitis: incidence and risk of esophageal adenocarcinoma - a population-based cohort study.  Am J Gastroenterol. 2006;  101 (6) 1193-1199
• 13 Malfertheiner de P, Peitz U. The interplay between Helicobacter pylori, gastro-oesophageal reflux disease, and intestinal metaplasia.  Gut. 2005;  54 Suppl 1 i13-i20
• 14 Anandasabapathy S, Jhamb J, Davila M. et al . Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia.  Cancer. 2007;  109 (4) 668-674
• 15 Sharma P, Dent J, Armstrong D. et al . The development and validation of an endoscopic grading system for Barrett’s esophagus: the Prague C & M criteria.  Gastroenterology. 2006;  131 (5) 1392-1399
• 16 Theisen J, Stein H J, Dittler H J. et al . Preoperative chemotherapy unmasks underlying Barrett’s mucosa in patients with adenocarcinoma of the distal esophagus.  Surg Endosc. 2002;  16 (4) 671-673
• 17 Hamilton R, Aaltonen L A. Tumors of the gastrointestinal system; WHO classification. Lyon; IARC Press 2000
• 18 Rahden B H, Stein H J, Siewert J R. Surgical management of esophagogastric junction tumors.  World J Gastroenterol. 2006;  12 (41) 6608-6613
• 19 Schlemper R J, Riddell R H, Kato von Y. et al . The Vienna classification of gastrointestinal epithelial neoplasia.  Gut. 2000;  47 (2) 251-255
• 20 Bollschweiler E, Wolfgarten E, Gutschow C. et al . Demographic variations in the rising incidence of esophageal adenocarcinoma in white males.  Cancer. 2001;  92 (3) 549-555
• 21 Devesa S S, Blot W J, Fraumeni J F Jr. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States.  Cancer. 1998;  83 (10) 2049-2053
• 22 Bytzer P, Christensen P B, Damkier P. et al . Adenocarcinoma of the esophagus and Barrett’s esophagus: a population-based study.  Am J Gastroenterol. 1999;  94 (1) 86-91
• 23 Corley D A, Buffler P A. Oesophageal and gastric cardia adenocarcinomas: analysis of regional variation using the Cancer Incidence in Five Continents database.  Int J Epidemiol. 2001;  30 (6) 1415-1425
• 24 Corley D A, Kubo A. Influence of site classification on cancer incidence rates: an analysis of gastric cardia carcinomas.  J Natl Cancer Inst. 2004;  96 (18) 1383-1387
• 25 Nguyen A M, Luke C G, Roder D. Comparative epidemiological characteristics of oesophageal adenocarcinoma and other cancers of the oesophagus and gastric cardia.  Asian Pac J Cancer Prev. 2003;  4 (3) 225-231
• 26 Bareiss D, Stabenow R, Muller R. et al . [Current epidemiology of carcinoma of the esophagus and cardia in Germany].  Dtsch Med Wochenschr. 2002;  127 (25 - 26) 1367-1374
• 27 Chow W H, Blot W J, Vaughan T L. et al . Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia.  J Natl Cancer Inst. 1998;  90 (2) 150-155
• 28 Jonge P J, Steyerberg E W, Kuipers E J. et al . Risk factors for the development of esophageal adenocarcinoma in Barrett’s esophagus.  Am J Gastroenterol. 2006;  101 (7) 1421-1429
• 29 Guardino J M, Khandwala de F, Lopez R. et al . Barrett’s esophagus at a tertiary care center: association of age on incidence and prevalence of dysplasia and adenocarcinoma.  Am J Gastroenterol. 2006;  101 (10) 2187-2193
• 30 Lagergren J, Bergstrom R, Nyren O. Association between body mass and adenocarcinoma of the esophagus and gastric cardia.  Ann Intern Med. 1999;  130 (11) 883-890
• 31 Lagergren J, Bergstrom R, Lindgren A. et al . Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma.  N Engl J Med. 1999;  340 (11) 825-831
• 32 Wu A H, Wan P, Bernstein L. A multiethnic population-based study of smoking, alcohol and body size and risk of adenocarcinomas of the stomach and esophagus (United States).  Cancer Causes Control. 2001;  12 (8) 721-732
• 33 El Serag H B, Sonnenberg A. Opposing time trends of peptic ulcer and reflux disease.  Gut. 1998;  43 (3) 327-333
• 34 Kendall B J, Whiteman D C. Temporal changes in the endoscopic frequency of new cases of Barrett’s esophagus in an Australian health region.  Am J Gastroenterol. 2006;  101 (6) 1178-1182
• 35 Conio M, Cameron A J, Romero Y. et al . Secular trends in the epidemiology and outcome of Barrett’s oesophagus in Olmsted County, Minnesota.  Gut. 2001;  48 (3) 304-309
• 36 Hurschler D, Borovicka J, Neuweiler J. et al . Increased detection rates of Barrett’s oesophagus without rise in incidence of oesophageal adenocarcinoma.  Swiss Med Wkly. 2003;  133 (37 - 38) 507-514
• 37 Prach A T, MacDonald T A, Hopwood D A. et al . Increasing incidence of Barrett’s oesophagus: education, enthusiasm, or epidemiology?.  Lancet. 1997;  350 (9082) 933
• 38 Soest E M, Dieleman J P, Siersema P D. et al . Increasing incidence of Barrett’s oesophagus in the general population.  Gut. 2005;  54 (8) 1062-1066
• 39 Hagen J A, DeMeester S R, Peters J H. et al . Curative resection for esophageal adenocarcinoma: analysis of 100 en bloc esophagectomies.  Ann Surg. 2001;  234 (4) 520-530
• 40 Sihvo E I, Luostarinen M E, Salo J A. Fate of patients with adenocarcinoma of the esophagus and the esophagogastric junction: a population-based analysis.  Am J Gastroenterol. 2004;  99 (3) 419-424
• 41 Victorzon van M, Tolonen P, Kohonen M. et al . Outcome of surgery for oesophageal carcinoma in a low volume centre, with and without preoperative chemoradiotherapy.  Scand J Surg. 2004;  93 (1) 37-42
• 42 Van Veldhuyzen Zanten S J, Thomson A B, Barkun A N. et al . The prevalence of Barrett’s oesophagus in a cohort of 1040 Canadian primary care patients with uninvestigated dyspepsia undergoing prompt endoscopy.  Aliment Pharmacol Ther. 2006;  23 (5) 595-599
• 43 Solaymani-Dodaran M, Logan R F, West J. et al . Risk of oesophageal cancer in Barrett’s oesophagus and gastro-oesophageal reflux.  Gut. 2004;  53 (8) 1070-1074
• 44 Solaymani-Dodaran M, Logan R F, West J. et al . Mortality associated with Barrett’s esophagus and gastroesophageal reflux disease diagnoses - a population-based cohort study.  Am J Gastroenterol. 2005;  100 (12) 2616-2621
• 45 Jankowski J A, Provenzale D, Moayyedi P. Esophageal adenocarcinoma arising from Barrett’s metaplasia has regional variations in the west.  Gastroenterology. 2002;  122 (2) 588-590
• 46 Armstrong D. Review article: towards consistency in the endoscopic diagnosis of Barrett’s oesophagus and columnar metaplasia.  Aliment Pharmacol Ther. 2004;  20 Suppl 5 40-47
• 47 Hanna S, Rastogi A, Weston A P. et al . Detection of Barrett’s esophagus after endoscopic healing of erosive esophagitis.  Am J Gastroenterol. 2006;  101 (7) 1416-1420
• 48 Sharma P, Weston A P, Topalovski M. et al . Magnification chromoendoscopy for the detection of intestinal metaplasia and dysplasia in Barrett’s oesophagus.  Gut. 2003;  52 (1) 24-27
• 49 Kiesslich R, Neurath M F, Galle P R. Chromoendoscopy and magnifying endoscopy in patients with gastroesophageal reflux disease. Useful or negligible?.  Dig Dis. 2004;  22 (2) 142-147
• 50 Kiesslich R, Bergh von M, Hahn M. et al . Chromoendoscopy with indigocarmine improves the detection of adenomatous and nonadenomatous lesions in the colon.  Endoscopy. 2001;  33 (12) 1001-1006
• 51 Kiesslich R, Hahn M, Herrmann G. et al . Screening for specialized columnar epithelium with methylene blue: chromoendoscopy in patients with Barrett’s esophagus and a normal control group.  Gastrointest Endosc. 2001;  53 (1) 47-52
• 52 Guelrud M, Herrera I, Essenfeld H. et al . Enhanced magnification endoscopy: a new technique to identify specialized intestinal metaplasia in Barrett’s esophagus.  Gastrointest Endosc. 2001;  53 (6) 559-565
• 53 Guelrud M, Herrera I. Acetic acid improves identification of remnant islands of Barrett’s epithelium after endoscopic therapy.  Gastrointest Endosc. 1998;  47 (6) 512-515
• 54 Endo T, Awakawa T, Takahashi H. et al . Classification of Barrett’s epithelium by magnifying endoscopy.  Gastrointest Endosc. 2002;  55 (6) 641-647
• 55 Ferguson D D, DeVault K R, Krishna M. et al . Enhanced magnification-directed biopsies do not increase the detection of intestinal metaplasia in patients with GERD.  Am J Gastroenterol. 2006;  101 (7) 1611-1616
• 56 Meining A, Rosch T, Kiesslich R. et al . Inter- and intra-observer variability of magnification chromoendoscopy for detecting specialized intestinal metaplasia at the gastroesophageal junction.  Endoscopy. 2004;  36 (2) 160-164
• 57 Dickman R, Bautista J M, Wong W M. et al . Comparison of esophageal acid exposure distribution along the esophagus among the different gastroesophageal reflux disease (GERD) groups.  Am J Gastroenterol. 2006;  101 (11) 2463-2469
• 58 Sharma P, McQuaid K, Dent J. et al . A critical review of the diagnosis and management of Barrett’s esophagus: the AGA Chicago Workshop.  Gastroenterology. 2004;  127 (1) 310-330
• 59 Fountoulakis A, Zafirellis K D, Dolan K. et al . Effect of surveillance of Barrett’s oesophagus on the clinical outcome of oesophageal cancer.  Br J Surg. 2004;  91 (8) 997-1003
• 60 Sandick J W, Lanschot van J J, Kuiken B W. et al . Impact of endoscopic biopsy surveillance of Barrett’s oesophagus on pathological stage and clinical outcome of Barrett’s carcinoma.  Gut. 1998;  43 (2) 216-222
• 61 Eisen G M, Sandler R S, Murray van S. et al . The relationship between gastroesophageal reflux disease and its complications with Barrett’s esophagus.  Am J Gastroenterol. 1997;  92 (1) 27-31
• 62 Dickman R, Kim J L, Camargo L. et al . Correlation of gastroesophageal reflux disease symptoms characteristics with long-segment Barrett’s esophagus.  Dis Esophagus. 2006;  19 (5) 360-365
• 63 Gerson L B, Shetler K, Triadafilopoulos G. Prevalence of Barrett’s esophagus in asymptomatic individuals.  Gastroenterology. 2002;  123 (2) 461-467
• 64 Rex D K, Cummings O W, Shaw M. et al . Screening for Barrett’s esophagus in colonoscopy patients with and without heartburn.  Gastroenterology. 2003;  125 (6) 1670-1677
• 65 Sampliner R E. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. The Practice Parameters Committee of the American College of Gastroenterology.  Am J Gastroenterol. 1998;  93 (7) 1028-1032
• 66 Cameron A J, Carpenter H A. Barrett’s esophagus, high-grade dysplasia, and early adenocarcinoma: a pathological study.  Am J Gastroenterol. 1997;  92 (4) 586-591
• 67 Falk G W, Rice T W, Goldblum J R. et al . Jumbo biopsy forceps protocol still misses unsuspected cancer in Barrett’s esophagus with high-grade dysplasia.  Gastrointest Endosc. 1999;  49 (2) 170-176
• 68 Heitmiller R F. Prophylactic esophagectomy in Barrett esophagus with high-grade dysplasia.  Langenbecks Arch Surg. 2003;  388 (2) 83-87
• 69 Heitmiller R F, Redmond M, Hamilton S R. Barrett’s esophagus with high-grade dysplasia. An indication for prophylactic esophagectomy.  Ann Surg. 1996;  224 (1) 66-71
• 70 Reid B J, Blount P L, Feng Z. et al . Optimizing endoscopic biopsy detection of early cancers in Barrett’s high-grade dysplasia.  Am J Gastroenterol. 2000;  95 (11) 3089-3096
• 71 Buttar N S, Wang K K, Sebo T J. et al . Extent of high-grade dysplasia in Barrett’s esophagus correlates with risk of adenocarcinoma.  Gastroenterology. 2001;  120 (7) 1630-1639
• 72 Rice T W. Pro: esophagectomy is the treatment of choice for high-grade dysplasia in Barrett’s esophagus.  Am J Gastroenterol. 2006;  101 (10) 2177-2179
• 73 Ell C, May A, Gossner L. et al . Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett’s esophagus.  Gastroenterology. 2000;  118 (4) 670-677
• 74 May A, Gossner L, Pech O. et al . Local endoscopic therapy for intraepithelial high-grade neoplasia and early adenocarcinoma in Barrett’s oesophagus: acute-phase and intermediate results of a new treatment approach.  Eur J Gastroenterol Hepatol. 2002;  14 (10) 1085-1091
• 75 May A, Gossner L, Pech O. et al . Intraepithelial high-grade neoplasia and early adenocarcinoma in short-segment Barrett’s esophagus (SSBE): curative treatment using local endoscopic treatment techniques.  Endoscopy. 2002;  34 (8) 604-610
• 76 Pech O, May A, Gossner L. et al . Curative endoscopic therapy in patients with early esophageal squamous-cell carcinoma or high-grade intraepithelial neoplasia.  Endoscopy. 2007;  39 (1) 30-35
• 77 Ormsby A H, Petras R E, Henricks W H. et al . Observer variation in the diagnosis of superficial oesophageal adenocarcinoma.  Gut. 2002;  51 (5) 671-676
• 78 Schnell T G, Sontag S J, Chejfec G. et al . Long-term nonsurgical management of Barrett’s esophagus with high-grade dysplasia.  Gastroenterology. 2001;  120 (7) 1607-1619
• 79 Vieth M, Stolte M. Barrett’s esophagus and neoplasia: data from the Bayreuth Barrett’s archive.  Gastroenterology. 2002;  122 (2) 590-591
• 80 Seewald S, Akaraviputh T, Seitz U. et al . Circumferential EMR and complete removal of Barrett’s epithelium: a new approach to management of Barrett’s esophagus containing high-grade intraepithelial neoplasia and intramucosal carcinoma.  Gastrointest Endosc. 2003;  57 (7) 854-859
• 81 May A, Gossner L, Behrens A. et al . A prospective randomized trial of two different endoscopic resection techniques for early stage cancer of the esophagus.  Gastrointest Endosc. 2003;  58 (2) 167-175
• 82 Kakushima N, Fujishiro M, Kodashima S. et al . A learning curve for endoscopic submucosal dissection of gastric epithelial neoplasms.  Endoscopy. 2006;  38 (10) 991-995
• 83 Rosch T, Sarbia M, Schumacher B. et al . Attempted endoscopic en bloc resection of mucosal and submucosal tumors using insulated-tip knives: a pilot series.  Endoscopy. 2004;  36 (9) 788-801
• 84 Peters F P, Kara M A, Rosmolen W D. et al . Stepwise radical endoscopic resection is effective for complete removal of Barrett’s esophagus with early neoplasia: a prospective study.  Am J Gastroenterol. 2006;  101 (7) 1449-1457
• 85 Schlemper R J, Hirata I, Dixon M F. The macroscopic classification of early neoplasia of the digestive tract.  Endoscopy. 2002;  34 (2) 163-168
• 86 Pech O, May A, Gunter E. et al . The impact of endoscopic ultrasound and computed tomography on the TNM staging of early cancer in Barrett’s esophagus.  Am J Gastroenterol. 2006;  101 (10) 2223-2229
• 87 Holscher A H, Bollschweiler E, Schneider P M. et al . Early adenocarcinoma in Barrett’s oesophagus.  Br J Surg. 1997;  84 (10) 1470-1473
• 88 Stein H J, Feith M, Mueller J. et al . Limited resection for early adenocarcinoma in Barrett’s esophagus.  Ann Surg. 2000;  232 (6) 733-742
• 89 Rice T W, Zuccaro G Jr, Adelstein D J. et al . Esophageal carcinoma: depth of tumor invasion is predictive of regional lymph node status.  Ann Thorac Surg. 1998;  65 (3) 787-792
• 90 Ruol A, Merigliano S, Baldan N. et al . Prevalence, management and outcome of early adenocarcinoma (pT1) of the esophago-gastric junction. Comparison between early cancer in Barrett’s esophagus (type I) and early cancer of the cardia (type II).  Dis Esophagus. 1997;  10 (3) 190-195
• 91 van Sandick J W, van Lanschot J J, ten Kate F J. et al . Pathology of early invasive adenocarcinoma of the esophagus or esophagogastric junction: implications for therapeutic decision making.  Cancer. 2000;  88 (11) 2429-2437
• 92 Bollschweiler E, Baldus S E, Schroder W. et al . High rate of lymph-node metastasis in submucosal esophageal squamous-cell carcinomas and adenocarcinomas.  Endoscopy. 2006;  38 (2) 149-156
• 93 Vieth M, Rosch T. Endoscopic mucosal resection and the risk of lymph-node metastases: indications revisited?.  Endoscopy. 2006;  38 (2) 175-179
• 94 Guidelines for the clinical and pathological studies of carcinoma of the esophagus. March 1992 (8th edition): Japanese society of esophageal diseases. Tokyo; Kanehara and Co 2003
• 95 Ell C, May A, Pech O. et al . Curative endoscopic resection of early esophageal adenocarcinomas (Barrett’s cancer).  Gastrointest Endosc. 2007;  65 (1) 3-10
• 96 Pech O, Gossner L, May A. et al . Long-term results of photodynamic therapy with 5-aminolevulinic acid for superficial Barrett’s cancer and high-grade intraepithelial neoplasia.  Gastrointest Endosc. 2005;  62 (1) 24-30
• 97 Avidan B, Sonnenberg A, Schnell T G. et al . Hiatal hernia size, Barrett’s length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma.  Am J Gastroenterol. 2002;  97 (8) 1930-1936
• 98 Avidan B, Sonnenberg A, Schnell T G. et al . Hiatal hernia and acid reflux frequency predict presence and length of Barrett’s esophagus.  Dig Dis Sci. 2002;  47 (2) 256-264
• 99 Inomata Y, Koike T, Ohara S. et al . Preservation of gastric acid secretion may be important for the development of gastroesophageal junction adenocarcinoma in Japanese people, irrespective of the H. pylori infection status.  Am J Gastroenterol. 2006;  101 (5) 926-933
• 100 Cooper B T, Chapman W, Neumann C S. et al . Continuous treatment of Barrett’s oesophagus patients with proton pump inhibitors up to 13 years: observations on regression and cancer incidence.  Aliment Pharmacol Ther. 2006;  23 (6) 727-733
• 101 Hillman L C, Chiragakis L, Shadbolt B. et al . Proton-pump inhibitor therapy and the development of dysplasia in patients with Barrett’s oesophagus.  Med J Aust. 2004;  180 (8) 387-391
• 102 El Serag H B, Aguirre T, Kuebeler M. et al . The length of newly diagnosed Barrett’s oesophagus and prior use of acid suppressive therapy.  Aliment Pharmacol Ther. 2004;  19 (12) 1255-1260
• 103 Jankowski J A, Perry I, Harrison R F. Gastro-oesophageal cancer: death at the junction.  BMJ. 2000;  321 (7259) 463-464
• 104 El Serag H B, Aguirre T V, Davis S. et al . Proton pump inhibitors are associated with reduced incidence of dysplasia in Barrett’s esophagus.  Am J Gastroenterol. 2004;  99 (10) 1877-1883
• 105 Malfertheiner P, Lind T, Willich S. et al . Prognostic influence of Barrett’s oesophagus and Helicobacter pylori infection on healing of erosive gastro-oesophageal reflux disease (GORD) and symptom resolution in non-erosive GORD: report from the ProGORD study.  Gut. 2005;  54 (6) 746-751
• 106 Ouatu-Lascar R, Fitzgerald R C, Triadafilopoulos G. Differentiation and proliferation in Barrett’s esophagus and the effects of acid suppression.  Gastroenterology. 1999;  117 (2) 327-335
• 107 Peters F T, Ganesh S, Kuipers E J. et al . Endoscopic regression of Barrett’s oesophagus during omeprazole treatment; a randomised double blind study.  Gut. 1999;  45 (4) 489-494
• 108 Fitzgerald R C, Omary M B, Triadafilopoulos G. Dynamic effects of acid on Barrett’s esophagus. An ex vivo proliferation and differentiation model.  J Clin Invest. 1996;  98 (9) 2120-2128
• 109 Feagins L A, Zhang H Y, Hormi-Carver K. et al . Acid has antiproliferative effects in nonneoplastic Barrett’s epithelial cells.  Am J Gastroenterol. 2007;  102 (1) 10-20
• 110 Souza R F, Shewmake K, Terada L S. et al . Acid exposure activates the mitogen-activated protein kinase pathways in Barrett’s esophagus.  Gastroenterology. 2002;  122 (2) 299-307
• 111 Umansky M, Yasui W, Hallak A. et al . Proton pump inhibitors reduce cell cycle abnormalities in Barrett’s esophagus.  Oncogene. 2001;  20 (55) 7987-7991
• 112 Anderson L A, Johnston B T, Watson R G. et al . Nonsteroidal anti-inflammatory drugs and the esophageal inflammation-metaplasia-adenocarcinoma sequence.  Cancer Res. 2006;  66 (9) 4975-4982
• 113 Corley D A, Kerlikowske K, Verma R. et al . Protective association of aspirin/NSAIDs and esophageal cancer: a systematic review and meta-analysis.  Gastroenterology. 2003;  124 (1) 47-56
• 114 Farrow D C, Vaughan T L, Hansten P D. et al . Use of aspirin and other nonsteroidal anti-inflammatory drugs and risk of esophageal and gastric cancer.  Cancer Epidemiol Biomarkers Prev. 1998;  7 (2) 97-102
• 115 Funkhouser E M, Sharp G B. Aspirin and reduced risk of esophageal carcinoma.  Cancer. 1995;  76 (7) 1116-1119
• 116 Gammon M D, Terry M B, Arber N. et al . Nonsteroidal anti-inflammatory drug use associated with reduced incidence of adenocarcinomas of the esophagus and gastric cardia that overexpress cyclin D 1: a population-based study.  Cancer Epidemiol Biomarkers Prev. 2004;  13 (1) 34-39
• 117 Heath E I, Canto M I, Piantadosi S. et al . Secondary chemoprevention of Barrett’s esophagus with celecoxib: results of a randomized trial.  J Natl Cancer Inst. 2007;  99 (7) 545-557
• 118 Jankowski J, Barr H. Improving surveillance for Barrett’s oesophagus: AspECT and BOSS trials provide an evidence base.  BMJ. 2006;  332 (7556) 1512
• 119 Corley D A, Levin T R, Habel L A. et al . Barrett’s esophagus and medications that relax the lower esophageal sphincter.  Am J Gastroenterol. 2006;  101 (5) 937-944
• 120 Lagergren J, Bergstrom R, Adami H O. et al . Association between medications that relax the lower esophageal sphincter and risk for esophageal adenocarcinoma.  Ann Intern Med. 2000;  133 (3) 165-175
• 121 Vaughan T L, Farrow D C, Hansten P D. et al . Risk of esophageal and gastric adenocarcinomas in relation to use of calcium channel blockers, asthma drugs, and other medications that promote gastroesophageal reflux.  Cancer Epidemiol Biomarkers Prev. 1998;  7 (9) 749-756
• 122 Gutschow C A, Schroder W, Prenzel K. et al . Impact of antireflux surgery on Barrett’s esophagus.  Langenbecks Arch Surg. 2002;  387 (3 - 4) 138-145
• 123 Hofstetter W L, Peters J H, DeMeester T R. et al . Long-term outcome of antireflux surgery in patients with Barrett’s esophagus.  Ann Surg. 2001;  234 (4) 532-538
• 124 Ye W, Chow W H, Lagergren J. et al . Risk of adenocarcinomas of the esophagus and gastric cardia in patients with gastroesophageal reflux diseases and after antireflux surgery.  Gastroenterology. 2001;  121 (6) 1286-1293
• 125 Spechler S J, Lee E, Ahnen D. et al . Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial.  JAMA. 2001;  285 (18) 2331-2338
• 126 Lundell L, Miettinen P, Myrvold H E. et al . Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease.  J Am Coll Surg. 2001;  192 (2) 172-179
• 127 Parrilla P, Martinez de Haro L F, Ortiz A. et al . Long-term results of a randomized prospective study comparing medical and surgical treatment of Barrett’s esophagus.  Ann Surg. 2003;  237 (3) 291-298