Epidemiology & Etiology: Approximately 60% of cases of distal esophageal or gastroesophageal adenocarcinomas have evidence of Barrett’s esophagus. High-grade dysplasia is an indication for more aggressive management, including surgical resection. Tumor markers, such as TP53, may be predictors of potential progression to malignant disease. There is an inverse association between Helicobacter pylori (H. pylori) infection and adenocarcinomas of the lower esophagus, presumably a result of the reduced acidity associated with atrophic gastritis.9 Infection with human papillomavirus (HPV) has been correlated with an increased incidence of squamous cell cancers of the upper esophagus.10 Diagnosis: endoscopic ultrasound (EUS), have become more important in the evaluation and staging of esophageal cancer.11 EUS, in the hands of a skillful sonographer, can accurately assess the depth of penetration in as many as 90% of tumors and determine involveme...
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