Abstract
The main goal of this study was to evaluate the development of adenocarcinoma in patients with Barrett's esophagus. During the period from January 1975 to December 1985, a total of 134 patients had endoscopically severe esophagitis and/or Barrett's esophagus. In these patients, 32 (24%) met the macroscopic and histologic criteria for the diagnosis of Barrett's esophagus. A check-up study of these patients was performed in 1987. Adenocarcinoma developed in three patients during the follow-up period of 166.1 patient-years. Dysplasia in the columnar epithelium was found in two of these patients six and 15 months before the diagnosis of adenocarcinoma. The third patient with adenocarcinoma was detected in endoscopic follow-up in 1987. In addition, the endoscopic examination showed unchanged Barrett's epithelium in all but three patients despite the operative and/or medical treatment 3–12 years (mean 6.7 years) earlier. We conclude that Barrett's esophagus is a potential premalignant condition and careful endoscopic surveillance for dysplasia in the columnar epithelium of the distal esophagus is mandatory in patients with Barrett's esophagus.
Similar content being viewed by others
References
Bremner CG, Lynch VP, Ellis FH: Barrett's esophagus: Congenital or acquired? An experimental study of esophageal mucosal regeneration in the dog. Surgery 68:175–182, 1970
Goldman MC, Beckman RC: Barrett's syndrome: case report with discussion about concepts of pathogenesis. Gastroenterology 39:104–110, 1960
Spechler SJ, Robbins AH, Rubins HB, et al: Adenocarcinoma and Barrett's esophagus. An overrated risk? Gastroenterology 87:927–933, 1984
Cameron AJ, Ott BJ, Payne WS: The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus. N Engl J Med 313:857–859, 1985
Naef AP, Savary M, Ozzello L: Columnar-lined lower esophagus: An acquired lesion with malignant predisposition. Report on 140 cases of Barrett's esophagus with 12 adenocarcinomas. J Thorac Cardiovasc Surg 70:826–835, 1975
Spechler SJ, Goyal RK: Barrett's esophagus. N Engl J Med 315:362–371, 1986
Morson BC, Sobin LH, Grundmann E, Johanssen A, Nagayo T, Serck-Hanssen A: Precancerous conditions and epithelial dysplasia in the stomach. J Clin Pathol 33:711–721, 1980
Starnes VA, Aadkins RB, Ballinger JF, Sawyers JL: Barrett's esophagus. A surgical entity. Arch Surg 119:563–567, 1984
Skinner DB, Walther BC, Riddell RH, Schmidt H, Iascone C, DeMeester TR: Barrett's esophagus. Comparison of benign and malignant cases. Ann Surg 198:554–566, 1983
Radigan LR, Glover JL, Shipley FE, Shoemaker RE: Barrett's esophagus. Arch Surg 112:486–491, 1977
Finnish Cancer Registry. Cancer incidence in Finland 1983. Helsinki, Cancer of Society of Finland, 1987
Smith RRL, Hamilton SR, Boitnott JK, Rogers EL: The spectrum of carcinoma arising in Barrett's esophagus. A clinicopathologic study of 26 patients. Am J Surg Pathol 8:563–573, 1984
Rosenberg JC, Budev H, Edwards RC, Singal S, Steiger Z, Sundareson AS: Analysis of adenocarcinoma in Barrett's esophagus utilizing a staging system. Cancer 55:1353–1360, 1985
Riddell RH: Dysplasia and regression in Barrett's epithelium.In Barrett's Esophagus. Pathophysiology, Diagnosis and Management. SJ Spechler, RK Goyal (eds). New York, Elsevier, 1985, pp 143–152
Reid BJ, Weinstein WM, Lewin KJ, et al: Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma in Barrett's esophagus without grossly recognizable neoplastic lesions. Gastroenterology 94:81–90, 1988
Reid BJ, Haggitt RC, Rubin CE, et al: Observer variation in the diagnosis of dysplasia in Barrett's esophagus. Hum Pathol 19:166–178, 1988
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ovaska, J., Miettinen, M. & Kivilaakso, E. Adenocarcinoma arising in Barrett's esophagus. Digest Dis Sci 34, 1336–1339 (1989). https://doi.org/10.1007/BF01538065
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01538065