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Barrett's oesophagus (Barrett's metaplasia)

aka Barrett's, Barrett, Barrett's esophagus, Barrett oesophagus, Barrett's metaplasia, intestinal metaplasia

A change in the lining of the lower food pipe, caused by years of acid reflux, in which stomach-like cells replace the normal ones. It is the soil from which most Western oesophageal adenocarcinomas grow, though most people with it never get cancer.

Barrett's affects 1-2% of adults and carries roughly a 0.3% per year risk of adenocarcinoma, higher with long segments and dysplasia. Surveillance endoscopy with biopsies looks for dysplasia; high-grade dysplasia or intramucosal cancer is treated by endoscopic resection plus radiofrequency ablation of the remaining Barrett's, avoiding oesophagectomy. Non-endoscopic screening (Cytosponge with TFF3 staining, capsule sponges) and molecular risk stratification (TP53, p53 IHC) are being trialled to find the minority who will progress.

Category
Pathology & biomarkers

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