Natural History and Follow-up Strategy of Barrett's Esophagus

Lee, Soo Yeon; Kim, Sung Soo

doi:2012.12.2.67

Korean J Helicobacter Up Gastrointest Res > Volume 12(2); 2012 > Article

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(2):67-70.
DOI: https://doi.org/10.7704/kjhugr.2012.12.2.67 Published online June 10, 2012.

Natural History and Follow-up Strategy of Barrett's Esophagus

Soo Yeon Lee, Sung Soo Kim

Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea. kimss@catholic.ac.kr

바렛식도의 자연경과와 추적전략

이수연, 김성수

가톨릭대학교 의과대학 의정부성모병원 소화기내과

Abstract

Barrett's esophagus is defined as intestinal metaplasia in columnar mucosa of the esophagus from endoscopic mucosal biopsy. Barrett's esophagus is a complication of gastroesophageal reflux disease and is the leading cause of esophageal adenocarcinoma. According to recent data, the annual incidence of low grade dysplasia, high grade dysplasia, and adenocarcinoma in patients with Barrett's esophagus were 3.6%, 0.48%, and 0.27%, respectively. Annual incidence of esophageal adenocarcinoma in patients with low grade dysplasia is 0.6%, and that in high grade dysplasia is 5.6%. Endoscopic surveillance of Barrett's esophagus should be performed with the purpose of detecting dysplasia and adenocarcinoma. Endos-copic surveillance of Barrett's esophagus is recommended at an interval of 2~5 years, and if low grade dysplasia develops, then follow up endoscopy should be done at 2 months to 1 year interval. If high grade dysplasia is detected, then it should be resected endoscopically. Biopsy for detection of Barrett's esophagus is recommended as a random four quadrant biopsy of 2 cm intervals in the columnar metaplasia. However, due to the relatively low incidence of esophageal adenocarcinoma, low cost of endoscopic examination, and frequent endoscopic examination due to country-based gastric cancer surveillance program in our country, the foreign guideline of Barrett's esophagus should be adjusted to our circumstance.

Key Words: Barrett's esophagus; Dysplasia; Adenocarcinoma; Surveillance