, Volume 443, Issue 5, pp 602-608
Date: 27 Sep 2003

Report of an Amsterdam Working Group on Barrett Esophagus

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Introduction

More than 50 years have passed since Barrett described a case of peptic ulcer disease of the esophagus and the condition that would carry his name [1]. It is now generally accepted that Barrett esophagus is the result of long-standing gastroesophageal reflux disease leading to replacement of the normal stratified squamous epithelial lining of the esophagus by glandular epithelium of various types [24, 32]. The importance of a diagnosis of Barrett esophagus is its association with the development of an esophageal adenocarcinoma. In contrast to what Norman Barrett originally thought, Barrett esophagus is a premalignant condition, and the incidence of Barrett carcinoma has increased dramatically since his publication in 1950 [12].

Barrett adenocarcinoma is preceded by a well-defined premalignant lesion, i.e., dysplasia (intraepithelial neoplasia—IEN—according to the recent WHO nomenclature) [9, 14]. IEN, as a dependable morphological marker for cancer risk, provides a potential