%0 Journal Article
%T Histopathology of Barrett¡¯s Esophagus and Early-Stage Esophageal Adenocarcinoma: An Updated Review
%A David Hernandez Gonzalo
%A Feng Yin
%A Jinping Lai
%A Xiuli Liu
%J -
%D 2019
%R https://doi.org/10.3390/gidisord1010011
%X Abstract Esophageal adenocarcinoma carries a very poor prognosis. For this reason, it is critical to have cost-effective surveillance and prevention strategies and early and accurate diagnosis, as well as evidence-based treatment guidelines. Barrett¡¯s esophagus is the most important precursor lesion for esophageal adenocarcinoma, which follows a defined metaplasia¨Cdysplasia¨Ccarcinoma sequence. Accurate recognition of dysplasia in Barrett¡¯s esophagus is crucial due to its pivotal prognostic value. For early-stage esophageal adenocarcinoma, depth of submucosal invasion is a key prognostic factor. Our systematic review of all published data demonstrates a ¡°rule of doubling¡± for the frequency of lymph node metastases: tumor invasion into each progressively deeper third of submucosal layer corresponds with a twofold increase in the risk of nodal metastases (9.9% in the superficial third of submucosa (sm1) group, 22.0% in the middle third of submucosa (sm2) group, and 40.7% in deep third of submucosa (sm3) group). Other important risk factors include lymphovascular invasion, tumor differentiation, and the recently reported tumor budding. In this review, we provide a concise update on the histopathological features, ancillary studies, molecular signatures, and surveillance/management guidelines along the natural history from Barrett¡¯s esophagus to early stage invasive adenocarcinoma for practicing pathologists. View Full-Tex
%K Barrett¡¯s esophagus
%K intestinal metaplasia
%K low-grade dysplasia
%K high-grade dysplasia
%K intramucosal carcinoma
%K submucosal invasive adenocarcinoma
%U https://www.mdpi.com/2624-5647/1/1/11