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Mechanistic progression of EAC under the Western model

Determine the mechanistic progression from reflux esophagitis to Barrett's esophagus, dysplasia, and esophageal adenocarcinoma within the Western model of esophageal adenocarcinoma formation, specifying the biological pathways and transitions that drive this sequence of lesions.

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Background

Esophageal adenocarcinoma (EAC) typically arises through a sequence involving reflux esophagitis, Barrett's esophagus (BE), dysplasia, and carcinoma. Despite extensive research, the authors note that this progression remains incompletely characterized in the Western clinical model of EAC formation.

Clarifying this progression would improve early detection strategies, risk stratification, and mechanistic understanding of disease initiation and transformation in EAC.

References

While EAC is the most common pathological type in Western countries, the progression from reflux esophagitis to BE, dysplasia, and adenocarcinoma is not fully understood under the Western model of EAC formation 6.

— Defining the relationship between cathepsin B and esophageal adenocarcinoma: conjoint analysis of Mendelian randomization, transcriptome-wide association studies, and single-cell RNA sequencing data (2504.01270 - Li et al., 2 Apr 2025) in Introduction