Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Barrett's esophagus was diagnosed in 26 men in a five-year period by demonstrating esophageal specialized columnar epithelium in target biopsies obtained at endoscopy or in peroral suction biopsies of the esophageal mucosa. The clinical, radiologic and manometric features of these patients were reviewed retrospectively. Esophageal lesions associated with this epithelium included distal and midesophageal strictures and ulcers, alone or in combination, or simply esophagitis. One patient had an associated adenocarcinoma. Twenty of 26 (77%) had heartburn or regurgitation, 16 (62%) had easily elicited reflux of barium while supine and 16 of 17 tested had lower esophageal sphincter pressure in the incompetent range. Ninety-six percent had one or more of these parameters positive. This series demonstrates a wide spectrum of esophageal lesions in Barrett's esophagus, and supports the concept that this lesion occurs as a consequence of gastroesophageal reflux and erosive esophagitis. The case of adenocarcinoma in this series adds to the concern that the columnar lined lower esophagus may be a premalignant lesion.
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PMID:Barrett's esophagus. Clinical review of 26 cases. 68 53

Four cases of columnar epithelial-lined lower esophagus are presented. The condition can be complicated by esophagitis, ulceration, perforation, and adenocarcinoma of the esophagus. When the squamocolumnar junction is involved by peptic esophagitis, the area of mucosal transition appears as a tapered, strictured segment or a ring-line constriction some distance proximal to the muscular esophagogastric junction. Hiatal incompetence with massive gastroesophageal reflux was evident in 1 case. A deep penetrating ulcer may occur anywhere along the columnar epithelium, identical to peptic gastric ulceration. The columnar-lined lower esophagus should probably be considered a premalignant condition. Two of these patients had associated esophageal adenocarcinoma.
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PMID:The columnar epithelial-lined lower esophagus and its association with adenocarcinoma of the esophagus. 112 65

A case of adenocarcinoma developing at the squamocolumnar epithelial junction of a Barrett oesophagus is reported. This rare tumour was remarkable because of the youth of the patient and because of the signet-cell cytological pattern of the neoplasm. It is postulated that both the columnar epithelial lining of the lower part of the oesophagus and the malignant change are a consequence of long-standing oesophageal reflux.
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PMID:Adenocarcinoma in a Barrett oesophagus. 115 92

Squamous cell carcinoma is the most common malignant tumor of the esophagus and it is one of the most common fatal cancers worldwide. There is great geographic variation in occurrence of these tumors. Especially high-risk areas have been identified in Northern Iran, Central Asian Republics, Northern China and South Africa. In some of these areas annual mortality rates reach 133/100,000 and over 20% of the population dies of esophageal cancer. The mortality in the US is considerably lower (3 to 8 per 100,000). In common with squamous dysplasias elsewhere eg the cervix, squamous dysplasia of the esophagus also appears to be a precancerous lesion. We have found that squamous dysplasia and early cancer are characterized by a number of distinctive endoscopic changes, namely, mucosal friability, erosions, plaques and nodules. Another finding of interest is the failure on our part to confirm the frequency of esophagitis in high risk areas. Barrett's esophagus is an epithelial metaplasia which replaces esophageal squamous epithelium for variable lengths from the lower esophageal sphincter region cephalad. It is a complication that occurs in approximately 12% of patients with prolonged gastroesophageal reflux. The importance of this disorder is that it is associated with an increased risk of adenocarcinoma of the esophagus. In assessing biopsies from patients with Barrett's esophagus, the main role of the pathologist is to be on the alert for histologic features of dysplasia and adenocarcinoma. Since dysplasia in Barrett's is endoscopically invisible, multiple biopsies are necessary if surveillance is to be successful in detecting dysplastic lesions and early carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Malignant and premalignant lesions of the esophagus. 143 13

Barrett's oesophagus or columnar lined epithelium of the oesophagus (CLO) is a metaplastic condition associated with excessive gastro-oesophageal reflux. It is found in 15% of patients with reflux oesophagitis. In a detailed study of 115 CLO patients dysplasia was found in 46%; 13.9% were moderate or severe dysplasia, usually found in intestinal type CLO. Fifty patients were endoscoped annually to determine the natural history of the disease. The incidence of adenocarcinoma was 1 in 52 patient-years, a 125-fold excess risk. A dysplasia-carcinoma sequence was seen in the five who developed carcinoma. Patients with early carcinoma were treated surgically with 12% postoperative mortality and 100% survival for 24-70 months.
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PMID:Barrett's oesophagus. 146 82

There are a lot of contradiction and uncertainty related to Barrett's esophagus. Authors review the literature about the incidence, the aetiology, the pathology of the ailment, the possibility of diagnosis and treatment. 25 Barrett's esophagus were observed in the course of controlling of patients after antireflux operations and investigations of patients suffering from gastroesophageal reflux disease. X-ray examination, endoscopy, biopsy, 24-hour pH monitoring of the distal esophagus and esophageal manometry were performed. Because of the possibility of malignant transformation Barrett's esophagus requires yearly endoscopic surveillance and biopsy at least. Antireflux procedure does not protect against the development of adenocarcinoma.
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PMID:[Barrett esophagus]. 150 58

Current concepts regarding the nature and the treatment of Barrett's esophagus and its complications are reviewed. The columnar-lined lower esophagus is being increasingly recognized as an acquired condition caused by gastroesophageal reflux. Many patients are asymptomatic. Barrett's esophagus occurs in about 10% to 15% of patients with reflux esophagitis. The diagnosis depends on endoscopy and biopsy. Complications are common and include ulceration, stricture, dysplasia, and adenocarcinoma. Esophagitis, ulceration, and stricture can usually be treated medically. Surgical approaches are discussed for patients whose condition is refractory to medical therapy. The premalignant nature of Barrett's epithelium is well recognized, and strategies for surveillance and resection are discussed. Survival after resection of adenocarcinoma in Barrett's esophagus is not appreciably different from that of other carcinomas. Surveillance with endoscopy offers the best chance for early detection and cure.
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PMID:Current concepts concerning the nature and treatment of Barrett's esophagus and its complications. 846 28

A human pancreatic adenocarcinoma lambda gt11 expression library was differentially screened with mRNA derived from normal and cancerous pancreatic tissues. Five clones preferentially hybridized with pancreatic adenocarcinoma mRNA. cDNA inserts from 4 of these clones were amplified by PCR, labelled with alpha 32P and used in Northern blot analysis against mRNA prepared from a variety of tumour and normal tissues. lambda GER-4 identified a pancreas-associated mRNA (greater than 10 kb) with no homology with known sequences at either the nucleic or amino-acid level. lambda GER-2 identified a 1.7-kb mRNA transcript that was over-expressed in mRNA prepared from pancreas, colon, breast, lung and gastric tumours relative to normal tissues. Sequence analysis and restriction-enzyme mapping showed that this clone was completely homologous with the active form of human elongation factor EF-1 alpha. This high level of EF-1 alpha-mRNA expression in tumour tissues lends support to the increasing evidence that EF-1 alpha is an important regulator of the cell cycle.
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PMID:Differential screening of a human pancreatic adenocarcinoma lambda gt11 expression library has identified increased transcription of elongation factor EF-1 alpha in tumour cells. 154 8

Adenocarcinoma arising in Barrett's esophagus has recently been described in two children aged 11 and 14 years. The long-term follow-up of Barrett's esophagus in children is not well described. We evaluated 16 cases of Barrett's esophagus in children treated at this institution during the last 16 years. Ages ranged from 1.2 to 16 years (mean, 10.3 years). There were 11 boys and 5 girls. Barrett's esophagus was documented by endoscopy in 14 instances and at autopsy in 2 patients with secretory diarrhea and tetralogy of Fallot who died of sepsis. Two children had cancer (neuroblastoma, leukemia) and died of their malignant disease. Five patients had cerebral palsy, 1 esophageal atresia, 1 Fanconi's anemia, and 5 were otherwise normal children. Six were treated medically. Eight patients underwent Nissen fundoplication for complications of gastroesophageal reflux (GER). Five patients were available for follow-up endoscopy (mean, 2 years; range, 1.1 to 5.4 years). Endoscopy was performed on a yearly basis, obtaining biopsy specimens from multiple levels of the esophagus. Four children had satisfactory clinical response to an antireflux procedure including the resolution of a stricture in one case. However, in all 5 cases persistent metaplastic epithelium was documented and showed no evidence of regression. Although there has been speculation that Barrett's esophagus in children may be more likely to revert to normal squamous epithelium than in the adult, there has been only one case of regression in 180 cases of Barrett's esophagus occurring in children described in 37 reports in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Persistence of Barrett's esophagus in children after antireflux surgery: influence on follow-up care. 156 27

Pancreatic tumour-associated monoclonal antibody DD9E7, raised against the GER pancreatic adenocarcinoma cell line, recognises a protein epitope on a novel family of membrane-bound cell surface glycoproteins (Mr 80-115,000). Western blot analysis of SDS/PAGE gels of tumour biopsies and of normal adult pancreas has shown that these glycoproteins are highly expressed in most pancreatic tumours but cannot be detected in normal adult pancreas. Using monoclonal antibodies directed against other antigens that have been associated with pancreatic adenocarcinoma (Du-Pan-2, Ca 19-9, CEA, NCA-95/55, EMA, and FAP), we have been able to show that although some of the antigens are also expressed by the GER pancreatic tumour cell line, the glycoproteins identified by monoclonal antibody DD9E7 are distinct from those other antigens in both molecular weight and antibody binding characteristics. Neuraminidase, periodic acid, and tunicamycin treatment of cultured cells has shown that monoclonal antibody DD9E7 recognises an epitope on the protein core of the antigen. This epitope is also present in NCA-1, but not in CEA, which suggest that there may be an association between DD9-antigen and other members of the NCA/CEA supergene family.
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PMID:The identification of a novel NCA-related pancreatic tumour-associated antigen, DD9-antigen: a comparison with the expression of other tumour antigens by the pancreatic tumour cell line GER. 171 89


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