Barrett's Esophagus

Precancerous Stages Leading to Barrett's Esophagus

Biopsy specimens are classified into the following categories:

Barrett's mucosa — the lower esophagus is lined by red-colored tissue, not the usual white-pink color, and biopsies demonstrate stomach-like tissue but no cellular changes to indicate cancerous changes.

Dysplasia (pre-cancerous cells)

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Barrett's esophagus with low-grade dysplasia — Microscopic analysis of biopsies show the earliest signs of pre-cancerous changes. Some studies suggest that 1 percent of patients with low-grade dysplastic Barrett's esophagus will develop esophageal cancer each year.

Barrett's esophagus with high-grade dysplasia — biopsies show severe advanced pre-cancerous changes. This category was formerly called "carcinoma in situ" meaning the earliest changes of cancer at the esophagus surface. For these patients, the risk of developing advanced or invasive cancer is high, an estimated 10 percent per year. At this stage, intervention is usually recommended, either esophagus resection surgery or minimally invasive treatment such as photodynamic therapy (PDT).

Early esophageal cancer — this condition is a development of cancer at the esophagus surface, which has not yet spread or become an invasive cancer. Again, recommended treatment options are esophagus resection surgery, and depending on the extent, endoscopy treatments such as photodynamic therapy or endoscopic mocosual resection.