Abstrakt

Barrett’s esophagus represents the most important precancerous condition of esophageal adenocarcinoma with a prevalence of 1 – 2% in the general population. Endoscopic diagnosis forms the foundation of detection, classification and surveillance. In addition to standard high resolution white light endoscopy, image-enhanced techniques such as digital chromoendoscopy using Narrow Band Imaging, Blue Light Imaging and i-scan as well as acetic acid staining should be employed to detect dysplastic changes. Acetic acid staining increases sensitivity through the characteristic “de-whitening sign” of dysplastic areas. Suspicious lesions are classified according to Paris classification and the Barrett’s International Narrow Band Imaging Group (BING) classification systems. Endoscopic ultrasound shows methodological limitations for early lesions and is not routinely recommended before endoscopic resection of early neoplasia. The diagnostic approach follows established algorithms with targeted biopsies of suspicious areas and untargeted quadrant biopsies according to the Seattle protocol. Surveillance strategy depends on histological grading with intervals ranging from 3 to 5 years for non-dysplastic Barrett’s to quarterly controls after endoscopic resection of pT1 carcinomas. Artificial intelligence shows promising approaches for automated neoplasia detection. Multimodal endoscopic diagnosis enables precise risk stratification and stage-appropriate therapy planning in Barrett’s esophagus.

Autoreninformation

Autoren

• M.W. Scheppach¹
• A. Ebigbo²

Abteilungen

• ¹ III. Medizinische Klinik – Gastroenterologie, Universitätsklinikum Augsburg, Augsburg,
• ² Medizinische Klinik I – Universitätsklinikum St. Josef-Hospital, Bochum

Adresse

Markus W. Scheppach
3. Medizinische Klinik – Gastroenterologie
Universitätsklinikum Augsburg
Stenglinstrasse 2
86156 Augsburg
Email: [email protected]

Citation