Molecular biomarkers and ablative therapies for Barrett’s esophagus

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Chisolm, Jacob A
Mayne, George C
Hussey, Damian James
Watson, David Ian
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Informa Healthcare
© 2012, Informa Healthcare
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Informa Healthcare
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.
Author version made available in accordance with the publisher's policy.
Barrett esophagus, Ablation techniques, Esophagoscopy
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.