Barrett's esophagus (British English: Barrett's oesophagus), sometimes called Barrett syndrome, Barrett esophagus, or columnar epithelium lined lower oesophagus (CELLO), refers to an abnormal change (metaplasia) in the cells of the lower portion of the esophagus. It is characterized by the replacement of the normal stratified squamous epithelium lining of the esophagus by simple columnar epithelium with goblet cells (which are usually found lower in the gastrointestinal tract). The medical significance of Barrett's esophagus is its strong association (about 0.5% per patient-year) with esophageal adenocarcinoma, a very often deadly cancer, because of which it is considered to be a premalignant condition.
The main cause of Barrett's esophagus is thought to be an adaptation to chronic acid exposure from reflux esophagitis. The incidence of esophageal adenocarcinoma has increased substantially in the Western world in recent years. The condition is found in 5–15% of patients who seek medical care for heartburn (gastroesophageal reflux disease), although a large subgroup of patients with Barrett's esophagus do not have symptoms. Diagnosis requires endoscopy (more specifically, esophagogastroduodenoscopy, a procedure in which a fibreoptic cable is inserted through the mouth to examine the esophagus, stomach, and duodenum) andbiopsy. The cells of Barrett's esophagus, after biopsy, are classified into four general categories: nondysplastic, low-grade dysplasia, high-grade dysplasia, and frank carcinoma. High-grade dysplasia and early stages of adenocarcinoma can be treated by endoscopic resection and new endoscopic therapies such as radiofrequency ablation, whereas advanced stages (submucosal) are generally advised to undergo surgical treatment. Nondysplastic and low-grade patients are generally advised to undergo annual observation with endoscopy, with radiofrequency ablation as a therapeutic option. In high-grade dysplasia, the risk of developing cancer might be at 10% per patient-year or greater.
The condition is named after the Australian-born British thoracic surgeon Norman Barrett (1903–1979), who described it in 1950.
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http://www.gastrojournal.org/article/s0016-5085(08)02180-x/fulltext the association between alcohol and reflux esophagitis, barrett's esophagus, and esophageal adenocarcinoma by lesley a. anderson et al.,the association between alcohol and reflux esophagitis, barrett's esophagus, and esophageal adenocarcinoma by anderson, lesley a. et al. gastroenterology , volume 136 , issue 3 , 799 – 805
http://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-7-97 activation of akt is increased in the dysplasia-carcinoma sequence in barrett's oesophagus and contributes to increased proliferation and inhibition of apoptosis: a histopathological and functional study by ian lp beales et albmc cancer20077:97 doi: 10.1186/1471-2407-7-97