Barrett’s esophageal cancer: endoscopic diagnosis and treatment

Barrett’s esophagus, being a precancerous disease, increases the risks of adenocarcinoma development by several dozen times. In recent years, there has been an increase in the incidence of esophageal adenocarcinoma in a number of countries, which makes the problem of timely diagnosis of early neoplastic changes in the epithelium against the background of Barrett’s esophagus especially relevant. 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 GI 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%], lesions were found within the short segment of BE. Some patients (85.7%) underwent endoscopic removal of neoplasms, which was considered radical based on the results of a pathomorphological examination of surgical material. We identified several signs characteristic of mild and severe epithelial dysplasia, as well as non-invasive Barrett’s esophageal adenocarcinoma. We also described treatment strategies in case of detecting superficial neoplasms.