A new study shows that a specific test can help find which people with Barrett's esophagus have a higher risk of esophageal cancer. Barrett's esophagus is a condition associated with abnormal changes (called dysplasia) in the cells lining the esophagus. These changes are not cancerous, but they can become cancerous over time as the cells become more abnormal. Although all people with Barrett's esophagus are at risk for esophageal cancer, there has been no good way to find out who is more likely to develop cancer.
Typically, a person with Barrett's esophagus is monitored for precancerous changes or early-stage cancers by taking several biopsies of the esophagus during an endoscopy. An endoscopy is a test that allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. A biopsy is the removal of a small piece of tissue for examination under a microscope. Unfortunately, this method of screening may miss abnormal cells.
In this study, researchers examined the biopsy samples from 60 patients with Barrett's esophagus. Of these patients, 33 had no dysplasia or cancer and 27 had high-grade (very abnormal cells) dysplasia or cancer. By using a technique called spectroscopy that looks at patterns of light shined through cells from a biopsy and a special type of microscope that can detect very small cell changes, researchers found three different types of changes, called markers, in the cells lining the esophagus. The researchers were able to use these markers to tell the difference between Barrett's esophagus with no dysplasia and high-grade dysplasia/cancer, meaning they could determine which patients were more likely to develop cancer sooner.
What this means for patients
“Eventually, this approach could lead to a simpler and more effective monitoring program for patients with Barrett's. Such a program would identify people with high-risk Barrett's esophagus who need more intensive monitoring, and who may need treatment to destroy the precancerous tissue,” said lead researcher Randall Brand, MD, Professor of Medicine at the University of Pittsburgh. This type of monitoring for Barrett's esophagus is still being studied and is currently only available in clinical trials.
Questions to Ask Your Doctor
- Do I have Barrett's esophagus?
- What is my risk of esophageal cancer?
- How can I reduce my risk of esophageal cancer?
- What can be done to help find esophageal cancer early?
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