ESOFAGO DE BARRET PDF

The Barrett's esophagus BE is defined as endoscopically visible columnar mucosa at the distal esophagus, of any extension, proved to harbor intestinal metaplasia on biopsy, highlighted by the presence of goblet cells. Therefore, these patients must be on follow-up, in order to diagnose cancer early. BE patients have frequent alterations in esophageal physiologyc studies. Alkaline duodenogastroesophageal reflux seems to have important role. The development BE occurs in steps, initially with formation of cardiac type mucosa subsequent intestinalization.

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The Barrett's esophagus BE is defined as endoscopically visible columnar mucosa at the distal esophagus, of any extension, proved to harbor intestinal metaplasia on biopsy, highlighted by the presence of goblet cells. Therefore, these patients must be on follow-up, in order to diagnose cancer early.

BE patients have frequent alterations in esophageal physiologyc studies. Alkaline duodenogastroesophageal reflux seems to have important role. The development BE occurs in steps, initially with formation of cardiac type mucosa subsequent intestinalization. Futher progression can follow a sequence, from low grade dysplasia, to high grade dysplasia and esophageal adenocarcinoma.

Current follow-up is based on the presence of dysplasia. It has limitations, grouping patients heterogeneously. Different steps of carcinogenesis have been studied looking for an ideal prognostic marker. Uncontrolled proliferative activity, apoptosis inhibition, angiogenesis, tissue invasion and metastases formation are all implicated in cancer origin.

Some cycle cell molecules have been studied in BE, such as retinoblastoma protein, ciclins, kinase dependent ciclins and cell cycle inhibitors.

The P53 protein is one of the most investigated in the metaplasia-adenocarcinoma progression. Growth Factors, apoptotic proteins, telomers and DNA ploidy have also been searched. Increased proliferative activity has been implicated in Barrett's carcinogenesis and the Ki antigen, through imunohistochemical analysis, has become the the method of choice. Present in the nucleus, it is found in proliferative cells only. Some studies suport association between Ki activity and the metaplasia-dysplasia-adenocarcinoma sequence.

The results, however, are inconclusive and research should follow this way. A mortalidade proporcional por ACE foi significativamente maior nos pacientes com EB, especialmente nos com metaplasia intestinal, a qual foi oito vezes maior A displasia significa risco aumentado de ACE. O Ciclo Celular. Marcadores Celulares. Fatores de Crescimento. Ploidia do DNA.

Sua forma normal ou selvagem tem meia-vida curta e rapidamente desaparece do meio celular. Atividade Proliferativa e Ki Hong et al. Feith et al. Polkowski et al. Lauwers et al. Barrett NR.

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Barrett's esophagus, high-grade dysplasia, and early adenocarcinoma: a pathological study. Am J Gastroenterol. Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma.

N Engl J Med. The incidence of adenocarcinoma in columnar-lined Barrett's esophagus. The extent of Barrett's esophagus depends on the status of the lower esophageal sphincter and the degree of esophageal acid exposure.

J Thorac Cardiovasc Surg. Changing patterns in the incidence of esophageal and gastric carcinoma in the United States. New classification of oesophageal and gastric carcinomas derived from changing patterns in epidemiology.

Br J Cancer. Watson A. Arq Gastroenterol. Spechler SJ. The natural history of dysplasia and cancer in esophagitis and Barrett esophagus. J Clin Gastroenterol.

Mortality in Barrett's oesophagus: results from a population based study. Life expectancy and cancer risk in patients with Barrett's esophagus: a prospective controlled investigation. Am J Med. Oesophageal cancer is an uncommon cause of death in patients with Barrett's oesophagus. Final results from 10 year cohort of patients undergoing surveillance for Barrett's oesophagus: observational study.

Adenocarcinoma in Barrett's oesophagus: an overrated risk. Risk of adenocarcinoma in Barrett's oesophagus: population based study. Chandrasoma P. Pathophysiology of Barrett's esophagus. Semin Thorac Cardiovasc Surg. Inflammation and specialized intestinal metaplasia of cardiac mucosa is a manifestation of gastroesophageal reflux disease.

Histology of the gastroesophageal junction: an autopsy study. Am J Surg Pathol. Risk factors for Barrett's esophagus in community-based practice. GORGE consortium. Gastroenterology Outcomes Research Group in Endoscopy. Cyclooxygenase 2 expression in Barrett's esophagus and adenocarcinoma: Ex vivo induction by bile salts and acid exposure. DeMeester TR. Clinical biology of the Barrett's metaplasia, dysplasia to carcinoma sequence. Surg Oncol. Barrett's esophagus: development of dysplasia and adenocarcinoma.

Reid BJ. Barrett's esophagus and esophageal adenocarcinoma. Gastroenterol Clin North Am. Flow-cytometric and histological progression to malignancy in Barrett's esophagus: prospective endoscopic surveillance of a cohort. Comparison of benign and malignant cases. Barrett's oesophagus: from metaplasia to dysplasia and cancer. Observer variation in the diagnosis of dysplasia in Barrett's esophagus. Hum Pathol. Clinicopathologic and molecular analysis of high-grade dysplasia and early adenocarcinoma in short- versus long-segment Barrett esophagus.

An endoscopic biopsy protocol can differentiate high-grade dysplasia from early adenocarcinoma in Barrett's esophagus. Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma in Barrett's esophagus without grossly recognizable neoplastic lesions. Dysplasia as a predictive marker for invasive carcinoma in Barrett esophagus: a follow-up study based on cases from a diagnostic variability study.

Risk factors for the development of an adenocarcinoma in columnar-lined Barrett esophagus. Molecular evolution of the metaplasia-dysplasia-adenocarcinoma sequence in the esophagus. Am J Pathol. Hallmarks of cancer progression in Barrett's oesophagus. Molecular biology of Barrett's adenocarcinoma. Clinical and molecular pathology of the metaplasia-dysplasia-carcinoma sequence in Barrett's oesophagus. Curr Diag Pathol. Review article: a conceptual approach to understanding the molecular mechanisms of cancer development in Barrett's oesophagus.

Aliment Pharmacol Ther. Control of the cell cycle and apoptosis.

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