This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
True statement regarding Barrett's esophagus: September 2011 
Select and explain. 
A. Patient present with severe symptoms, B. Normal pH profile, C. Increased risk of squamous cell carcinoma, D. Metaplastic change in the lining mucosa of the esophagus
D: Metaplastic change in the lining mucosa of the esophagus
Answer: D: Metaplastic change in the lining mucosa of the esophagus 
Explanation: Ans. D: Metaplastic change in the lining mucosa of the esophagusBarrett's esophagus is a metaplastic change in the lining mucosa of the esophagus in response to chronic gastro-esophageal refluxEsophageal cancer:Impoant predisposing factors:- Excess alcohol- Smoking- Chronic achalasia- Tylosis- Barrett's esophagus- Plummer Vinson syndromeFeatures:- Progressive dysphagia (MC)- Weight loss- WeaknessEsophagoscopy is diagnosticChemotherapy:- Limited role- Cisplatin- Bleomycin- 5-FluorouracilMC type: Squamous cell CaMC site: Lower endMC site of adenoCa: Lower end.MC site of squamous cell Ca: Middle third