Neoplasia of Barrett’s esophagus: modern concepts of endoscopic diagnostics and experience of the P.A. Herzen Moscow Oncology Research Institute

Barrett’s esophagus (BE) is an precancerous condition in which the squamous epithelium of the esophagus is transformed into a columnar epithelium under the influence of the constant reflux of acid. Barrett’s esophagus precedes the development of adenocarcinoma, the incidence of which, according to various authors, has increased significantly over the past decades. However, with timely detection and treatment of Barrett’s esophagus and dysplasia, it is possible to stop neoplastic progression and, subsequently, affect the reduction of mortality from invasive adenocarcinoma of the esophagus. In the endoscopy department of the P.A. Herzen Moscow Oncology Research Institute, 760 patients were examined in 2012-2024, in whom Barrett’s esophagus was detected during upper endoscopy. The disease was detected in men 2 times more often than in women (526 vs 254). In more than half of the patients, we observed a long segment of BE metaplasia (55.3% [95% CI: 51.7%-58.8%]). Different types of epithelial neoplasia were detected in 177 examined patients, which accounted for 23% of the total number of patients with BE. It was found that the greatest number of be changes were detected within a long segment of metaplasia (74.5% [95% CI: 68.1%-80.9%]). In less than 24% of cases [95% CI: 17.4%-30.0%], neoplasias were found within the short segment of BE. We identified a number of signs of low- and high-grade dysplasia, as well as non-invasive Barrett’s carcinoma.