Gastro-Esophageal Junction Precancerosis: Histological Diagnostic Approach and Pathogenetic Insights.
Simple Summary: A diagnosis of Barrett's esophagus (BE) requires the macroscopic visualization of gastric-appearing mucosa in the esophagus and the identification of intestinal metaplasia on histologic examination. Histologic diagnosis of BE dysplasia can be challenging due to sampling error, pathol...
| Publicado en: | Cancers Vol. 15; no. 24; pp. 5725 - 5738 |
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| Autores principales: | , , |
| Formato: | pictorial review tables/charts Journal Article |
| Publicado: |
MDPI
Dec2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=174403375&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174403375 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20726694 B74B jtl: Cancers issn: 20726694 maglogo: N pubinfo: dt: Dec2023 vid: 15 iid: 24 pid: 97109 pub: MDPI artinfo: ui: 174403375 174403375 174403375 10.3390/cancers15245725 174403375 ppf: 5725 ppct: 13 formats: tig: atl: Gastro-Esophageal Junction Precancerosis: Histological Diagnostic Approach and Pathogenetic Insights. aug: au: Giacometti, Cinzia Gusella, Anna Cassaro, Mauro affil: Pathology Unit, Department of Diagnostic Services, ULSS 6 Euganea, 35131 Padova, Italy sug: subj: Barrett Esophagus Diagnosis Practice Guidelines Barrett Esophagus Risk Factors Pathology, Molecular Barrett Esophagus Physiopathology Gastric Mucosa Analysis Metaplasia Diagnosis Esophagus Pathology Gastroesophageal Reflux Complications Adenocarcinoma Risk Factors Esophageal Neoplasms Risk Factors Inflammation Pathology Epithelial Cells Physiopathology Genetics Epigenomics Pathologic Processes Risk Factors Histology Severity of Illness Pathologists Work Experiences Sampling Error Genes Evaluation Cell Cycle Evaluation Signal Transduction Evaluation Apoptosis Evaluation Genomics ab: Simple Summary: A diagnosis of Barrett's esophagus (BE) requires the macroscopic visualization of gastric-appearing mucosa in the esophagus and the identification of intestinal metaplasia on histologic examination. Histologic diagnosis of BE dysplasia can be challenging due to sampling error, pathologists' experience, interobserver variation, and difficulty in histologic interpretation: all these problems complicate patient management. In intestinal metaplasia, which occurs because of chronic gastresophageal reflux disease (GERD), the squamous epithelium converts to columnar epithelium, which is initially of the cardia type and devoid of goblet cells; it later develops goblet cell metaplasia and eventually dysplasia, which develops and progresses to adenocarcinoma because of the accumulation of multiple genetic and epigenetic alterations. Therefore, this review aims to provide an up-to-date and clear diagnostic approach to Barrett's esophagus and an overview of dysplasia's development's pathogenetic and molecular mechanisms. Barrett's esophagus (BE) was initially defined in the 1950s as the visualization of gastric-like mucosa in the esophagus. Over time, the definition has evolved to include the identification of goblet cells, which confirm the presence of intestinal metaplasia within the esophagus. Chronic gastro-esophageal reflux disease (GERD) is a significant risk factor for adenocarcinoma of the esophagus, as intestinal metaplasia can develop due to GERD. The development of adenocarcinomas related to BE progresses in sequence from inflammation to metaplasia, dysplasia, and ultimately carcinoma. In the presence of GERD, the squamous epithelium changes to columnar epithelium, which initially lacks goblet cells, but later develops goblet cell metaplasia and eventually dysplasia. The accumulation of multiple genetic and epigenetic alterations leads to the development and progression of dysplasia. The diagnosis of BE requires the identification of intestinal metaplasia on histologic examination, which has thus become an essential tool both in the diagnosis and in the assessment of dysplasia's presence and degree. The histologic diagnosis of BE dysplasia can be challenging due to sampling error, pathologists' experience, interobserver variation, and difficulty in histologic interpretation: all these problems complicate patient management. The development and progression of Barrett's esophagus (BE) depend on various molecular events that involve changes in cell-cycle regulatory genes, apoptosis, cell signaling, and adhesion pathways. In advanced stages, there are widespread genomic abnormalities with losses and gains in chromosome function, and DNA instability. This review aims to provide an updated and comprehensible diagnostic approach to BE based on the most recent guidelines available in the literature, and an overview of the pathogenetic and molecular mechanisms of its development. pubtype: Academic Journal doctype: pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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