TAILIEUCHUNG - Ebook Carly cancer of the gastrointestinal tract endoscopy, pathology, and treatment (1st edition): Part 2

(BQ) Part 2 book "Carly cancer of the gastrointestinal tract endoscopy, pathology, and treatment" presents the following contents: Detection of early cancer - Is endoscopic ultrasonography effective; endoscopic treatment; natural course of early cancer; surgical treatment and survival rate of early cancer. | III. Early Neoplasia in Barrett s Esophagus 1. Early Neoplasia in Barrett s Esophagus Manfred Stolte Michael Vieth Andrea May Liebwin Gossner Irina Dostler and Christian Ell 1. Introduction Over the last 10-20 years the incidence of adenocarcinomas in Barrett s esophagus has increased enormously in many Western countries 1-5 . The increase in these countries is greater than that of all other malignant epithelial tumors so that the term new epidemic has even been applied 6 . The aim of gastroenterologists and pathologists must therefore be to diagnose this neoplasia at as early a stage as possible and thus enable curative endoscopic therapy. A review of the older literature up to the middle of the 1990s leaves the impression that we are far from achieving this objective since these older publications report mostly advanced Barrett s adenocarcinomas with the 5-year survival rate varying between 7 and 20 7 . Over the last 5 years however as a result of great advances in diagnostic endoscopy there has been a positive change. Ever more frequently early-stage neoplasia is being detected endoscopically diagnosed in biopsy material and treated via the endoscope 8-11 . Ten years ago we at the Institute of Pathology of the Bayreuth Hospital diagnosed advanced Barrett s carcinomas almost exclusively. The above-mentioned progress in diagnostic endoscopy has resulted in an increase in the percentage of early neoplasias we have diagnosed over the last 5 years to 50 -60 . 2. How Histology Helps to Improve the Endoscopic Diagnosis of Early Neoplasia in Barrett s Esophagus Formerly it was believed that dysplasia of Barrett s mucosa could be diagnosed only histologically and therefore quadrant biopsies at intervals of 1-2cm were recommended 12 13 . Dysplasia however is defined as unequivocal intraepithelial neoplasia 14 . We therefore earlier postulated that where something new is growing the surface structure of the mucosa must also be altered and were of the opinion that with .

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