Molecular biomarkers and ablative therapies for Barrett’s esophagus

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Date
2012-09
Authors
Chisolm, Jacob A
Mayne, George C
Hussey, Damian James
Watson, David Ian
Journal Title
Journal ISSN
Volume Title
Publisher
Informa Healthcare
Rights
© 2012, Informa Healthcare
Rights Holder
Informa Healthcare
Abstract
Barrett’s esophagus is the major risk factor for esophageal adenocarcinoma. Endoscopic interventions which ablate Barrett’s esophagus mucosa lead to replacement with a new squamous (neosquamous) mucosa, but it can be difficult to achieve complete ablation. Knowing whether cancer is less likely to develop in neosquamous mucosa or residual Barrett’s esophagus after ablation is critical for determining the efficacy of treatment. This issue can be informed by assessing biomarkers that are associated with an increased risk of progression to adenocarcinoma. Although there are few post-ablation biomarker studies, evidence suggests that that neosquamous mucosa may have a reduced risk of adenocarcinoma in patients who have been treated for dysplasia or cancer, but some patients who do not have complete eradication of non-dysplastic Barrett’s esophagus may still be at risk. Biomarkers could be used to optimize endoscopic surveillance strategies following ablation, but this needs to be assessed by clinical studies and economic modeling.
Description
Author version made available in accordance with the publisher's policy.
Keywords
Barrett esophagus, Ablation techniques, Esophagoscopy
Citation
Chisholm JA, Mayne GC, Hussey DJ, Watson DI 2012, 'Molecular biomarkers and ablative therapies for Barrett's esophagus'. Expert Review of Gastroenterology and Hepatology, 6(5):567-81.