Topics

No Barrett-No Cancer: A Proposed New Paradigm for Prevention of Esophageal Adenocarcinoma.

07:00 EST 16th December 2019 | BioPortfolio

Summary of "No Barrett-No Cancer: A Proposed New Paradigm for Prevention of Esophageal Adenocarcinoma."

Esophageal adenocarcinoma is inflammation-associated cancer with a recognizable preneoplastic stage, Barrett esophagus. Barrett esophagus describes the metaplastic transformation of esophageal squamous mucosa into columnar epithelium that typically results secondary to mucosal damage caused by acidic gastroduodenal reflux. Continued acid reflux may then result in mucosal inflammation which results in progressive inflammation-induced genetic instability that may eventuate in esophageal adenocarcinoma. Barrett esophagus is the only recognized precursor lesion to esophageal carcinoma. Barrett mucosa is unique among preneoplastic lesions; ablation therapy results in restitution of a squamous epithelium reducing or eliminating accumulated genetic instabilities and resetting the biological clock progressing toward invasive cancer. However, recurrence of Barrett after ablation is common. We propose that both Barrett and recurrence of Barrett after ablation can be prevented and discuss how current approaches to therapy for gastroesophageal reflux disease, for Barrett screening, chemoprevention, and ablation therapy all might be reconsidered. We propose (1) improved approaches to Barrett prevention, (2) universal Barrett screening by linking Barrett screening to colon cancer screening, (3) ablation of all Barrett mucosa along with (4) acid-suppressive-antireflux therapy tailored to prevent development of Barrett or the recurrence of Barrett after ablation therapy. We propose that ultimately, treatment decisions for gastroesophageal reflux disease and prevention of Barrett esophagus and esophageal carcinoma should be based on assessing and maintaining esophageal mucosal integrity. This will require development and verification of specific measurements that reliably correlate with prevention of Barrett esophagus. We outline the new research and technical advances needed to cost-effectively achieve these goals.

Affiliation

Journal Details

This article was published in the following journal.

Name: Journal of clinical gastroenterology
ISSN: 1539-2031
Pages:

Links

DeepDyve research library

PubMed Articles [23556 Associated PubMed Articles listed on BioPortfolio]

Current management of Barrett esophagus and esophageal adenocarcinoma.

Barrett esophagus is found in 5% to 15% of patients with gastroesophageal reflux disease and is a precursor of esophageal adenocarcinoma, yet the condition often goes undiagnosed. Patients with reflux...

Targeting the COX1/2-Driven thromboxane A2 pathway suppresses Barrett's esophagus and esophageal adenocarcinoma development.

Barrett's esophagus (BE), a complication of gastroesophageal reflux disease (GERD), predisposes patients to esophageal adenocarcinoma (EAC). Reliable biomarkers for early detection and discovery of po...

Isoforms of RNF128 Regulate the Stability of Mutant P53 in Barrett's Esophageal Cells.

Barrett's esophagus (BE) can progress to dysplasia and esophageal adenocarcinoma (EAC), accompanied by mutations in TP53 that increase the stability of its product, p53. We analyzed BE tissues for mRN...

Association Between Levels of Hormones and Risk of Esophageal Adenocarcinoma and Barrett's Esophagus.

Esophageal adenocarcinoma (EAC) occurs most frequently in men. We performed a Mendelian randomization analysis to investigate whether genetic factors that regulate levels of sex hormones associated wi...

Association of Biomarkers for Human Papillomavirus With Survival Among Adults With Barrett High-grade Dysplasia and Esophageal Adenocarcinoma.

The presence of high-risk human papillomavirus (HPV) has been associated with a favorable outcome in Barrett high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). Nevertheless, the prognosti...

Clinical Trials [19633 Associated Clinical Trials listed on BioPortfolio]

Familial Barrett's Esophagus

This is a multi-center study whose aim is to define the epidemiology and genetics of Barrett's esophagus and adenocarcinoma. The researchers have studied families affected with Barrett's e...

Predicting Risk of Cancer in Barrett's Esophagus

The purpose of this study is to determine if there are any early changes in DNA markers of blood and esophageal tissue in people with gastric reflux, Barrett's esophagus or esophageal canc...

Microbiome Involvement With Barrett's Esophagus and Progression to Esophageal Adenocarcinoma

This study will examine the hypothesis that altered esophageal microbiome leads to the development of esophageal adenocarcinoma (EAC). The aims of the project are, firstly the confirmation...

Minimally Invasive Molecular Approaches for the Diagnosis of Barrett's Esophagus and Esophageal Adenocarcinoma

This study will evaluate if the sponge capsule device can accurately detect the presence of Barrett's Esophagus and prevalent dysplasia/adenocarcinoma detection, in a screening population,...

EsophaCap for the Detection of Early Esophageal Carcinoma

This study is to identify potential biomarkers for the early detection of Barrett's Esophagus, esophageal carcinoma (both adenocarcinoma and squamous cell carcinoma), and gastric cancer vi...

Medical and Biotech [MESH] Definitions

A condition with damage to the lining of the lower ESOPHAGUS resulting from chronic acid reflux (ESOPHAGITIS, REFLUX). Through the process of metaplasia, the squamous cells are replaced by a columnar epithelium with cells resembling those of the INTESTINE or the salmon-pink mucosa of the STOMACH. Barrett's columnar epithelium is a marker for severe reflux and precursor to ADENOCARCINOMA of the esophagus.

An adenocarcinoma characterized by the presence of varying combinations of clear and hobnail-shaped tumor cells. There are three predominant patterns described as tubulocystic, solid, and papillary. These tumors, usually located in the female reproductive organs, have been seen more frequently in young women since 1970 as a result of the association with intrauterine exposure to diethylstilbestrol. (From Holland et al., Cancer Medicine, 3d ed)

A voluntary organization concerned with the prevention and treatment of cancer through education and research.

A lesion with cytological characteristics associated with invasive adenocarcinoma but the tumor cells are confined to the GLANDULAR EPITHELIAL CELLS of origin. Adenocarcinoma in situ of the CERVIX and the LUNG are the most common.

Tumors or cancer of the ESOPHAGUS.

Quick Search


DeepDyve research library

Relevant Topics

Cancer Disease
Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer th...

Cancer
  Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...

Barrett's Esophagus
Barrett’s esophagus is a condition in which the tissue lining the esophagus—the muscular tube that carries food and liquids from the mouth to the stomach—is replaced by tissue that is similar to the intestinal lining. This process is ca...


Searches Linking to this Article