Commentary
See article on page 761The continuing tale of cytokeratins in Barrett's mucosa: As you like it
| The first 150 words of the full text of this article appear below. |
Barrett's adenocarcinoma (BA) has seen a rapid increase in incidence throughout the Western world. The diagnosis of BA is often at an advanced stage and is generally associated with a poor prognosis and a mean survival of less than one year. Adenocarcinomas however do not arise de novo but follow an established sequence from Barrett's metaplasia (BM) through dysplasia to neoplasia.
Efforts to intervene in the pathogenesis of oesophageal adenocarcinomas
have so far been disappointing. Reduction of gastro-oesophageal reflux
disease has led to minimal regression of BM and has yet to be shown to
have any impact on cancer prevention. Surveillance programmes for
patients with BM have had variable results and have raised important
questions about their cost effectiveness and of better risk
stratification of patients with BM. The prevalence of BM in the general
population is approximately 1-3%, with only 0.5-1% of patients with
BM converting to neoplasia each
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