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Pathology of barrett's oesophagus

Clare Parker, Estratios Alexandridis, John Plevris, James O'Hara, Simon Panter
BACKGROUND: Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. METHODS: A Medline search was performed using the terms "transnasal", "ultrathin", "small calibre", "endoscopy", "EGD" to identify relevant literature...
October 2016: Frontline Gastroenterology
Jérémie Jacques, Romain Legros, Jérome Rivory, Aurélie Charissoux, Denis Sautereau, Thierry Ponchon, Mathieu Pioche
INTRODUCTION: ESD is the treatment of choice for superficial neoplasms of the oesophagus; ESD is oncologically efficient and associated with less morbidity than the surgical alternative. ESD requires a high level of skill, being both technically challenging and time consuming. Therefore, ESD is often reserved for experts. A combination of a tunnel technique with clip-line traction may enable optimisation of oesophageal ESD. PATIENTS AND METHODS: From January 2015 to December 2016, we performed a prospective two-centre case study of consecutive "tunnel + clip" oesophageal ESD...
November 2017: Surgical Endoscopy
E Werbrouck, G De Hertogh, X Sagaert, G Coremans, H Willekens, I Demedts, R Bisschops
BACKGROUND: Endoscopic resection (ER) with or without ablation is the first choice treatment for early Barrett's neoplasia. Adequate staging is important to assure a good oncological outcome. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of pre-operative biopsies in patients who undergo ER for high-grade dysplasia (HGD) or early adenocarcinoma (EAC) in Barrett's oesophagus (BE) and the cardia. METHODS: Between November 2005-May 2012, 142 ERs performed in 137 patients were obtained...
October 2016: United European Gastroenterology Journal
O J Old, G R Lloyd, J Nallala, M Isabelle, L M Almond, N A Shepherd, C A Kendall, A C Shore, H Barr, N Stone
Barrett's oesophagus (BE) is a premalignant condition that can progress to oesophageal adenocarcinoma. Endoscopic surveillance aims to identify potential progression at an early, treatable stage, but generates large numbers of tissue biopsies. Fourier transform infrared (FTIR) mapping was used to develop an automated histology tool for detection of BE and Barrett's neoplasia in tissue biopsies. 22 oesophageal tissue samples were collected from 19 patients. Contiguous frozen tissue sections were taken for pathology review and FTIR imaging...
October 7, 2016: Analyst
Francesca Palombo, Marco Madami, Daniele Fioretto, Jayakrupakar Nallala, Hugh Barr, Antoine David, Nick Stone
Barrett's oesophagus is a condition characterized by a change in the lining of the oesophagus that markedly increases the risk of adenocarcinoma. We demonstrate the first site-matched application of Brillouin microscopy, Raman microscopy and FTIR micro-spectroscopic imaging to ex-vivo epithelial tissue - Barrett's oesophagus. The mechanical and chemical characters of the epithelium were assessed in histological sections from a patient subjected to endoscopic oesophageal biopsy. Previous studies have shown that both these properties change within the oesophageal wall, owing to the presence of distinct cellular and extracellular constituents which are putatively affected by oesophageal cancer...
July 2016: Journal of Biophotonics
Roger M Feakins
Obesity is an increasingly common problem worldwide and a risk factor for a variety of gastrointestinal (GI) diseases, both non-neoplastic (e.g. gastro-oesophageal reflux and Barrett's oesophagus) and neoplastic (e.g. oesophageal adenocarcinoma, colorectal carcinoma, and gallbladder cancer). Furthermore, obesity is associated with worse GI cancer outcomes. Body mass index is a commonly used measure of fat accumulation, although specific patterns such as abdominal/central obesity and visceral fat quantity sometimes predict disease risk more accurately...
April 2016: Histopathology
Lourdes Y Robles, Satish Singh, Piero Marco Fisichella
BACKGROUND: Despite advances in diagnoses and therapy, esophageal adenocarcinoma remains a highly lethal neoplasm. Hence, a great interest has been placed in detecting early lesions and in the detection of Barrett esophagus (BE). Advanced imaging technologies of the esophagus have then been developed with the aim of improving biopsy sensitivity and detection of preplastic and neoplastic cells. The purpose of this article was to review emerging imaging technologies for esophageal pathology, spectroscopy, confocal laser endomicroscopy (CLE), and optical coherence tomography (OCT)...
May 15, 2015: Journal of Surgical Research
A E Karateev, A E Movsiian, M M Anan'eva, S G Radenska-Lopovok
UNLABELLED: Oesophageal lesion is the commonest visceral manifestation of systemic scleroderma (SSD) affecting the quality of life and fraught with serious complications. The aim of this study was to evaluate clinical, endoscopic andmorphological manifestations of oesophageal lesion in systemic scleroderma and its relationships with other clinical symptoms and pharmacotherapy of the disease. MATERIALS AND METHODS: 479 patients with SSD (93.7% women, 6.3% men, mean age 48...
2014: Klinicheskaia Meditsina
Pieter J F de Jonge, Manon C Spaander, Marco J Bruno, Ernst J Kuipers
Gastro-oesophageal reflux disease is a common medical problem in developed countries, and is a risk factor for the development of Barrett's oesophagus and oesophageal adenocarcinoma. Both proton pump inhibitor therapy and antireflux surgery are effective at controlling endoscopic signs and symptoms of gastro-oesophageal reflux in patients with Barrett's oesophagus, but often fail to eliminate pathological oesophageal acid exposure. The current available studies strongly suggest that acid suppressive therapy, both pharmacological as well as surgical acid suppression, can reduce the risk the development and progression in patients with Barrett's oesophagus, but are not capable of complete prevention...
February 2015: Best Practice & Research. Clinical Gastroenterology
Gary W Falk
The incidence of oesophageal adenocarcinoma is continuing to increase at an alarming rate in the Western world today. Barrett's oesophagus is a clearly recognized risk factor for the development of oesophageal adenocarcinoma, but the overwhelming majority of patients with Barrett's oesophagus will never develop oesophageal cancer. A number of endoscopic, histologic and epidemiologic risk factors identify Barrett's oesophagus patients at increased risk for progression to high-grade dysplasia and oesophageal adenocarcinoma...
February 2015: Best Practice & Research. Clinical Gastroenterology
Bita V Naini, Amitabh Chak, Meer Akbar Ali, Robert D Odze
This review summarizes the endoscopic and histologic features of Barrett's oesophagus(BO) as well as some of the recent advancements and controversies. BO represents metaplastic conversion of normal squamous epithelium of tubular oesophagus to columnar epithelium. The diagnosis of BO requires a combination of endoscopic and histopathologic findings. There is worldwide controversy regarding the exact definition of BO, particularly with regard to the requirement to histologically identify goblet cells in biopsies...
February 2015: Best Practice & Research. Clinical Gastroenterology
Hiroshi Nakagawa, Kelly Whelan, John P Lynch
Barrett's oesophagus (BE) is defined as any metaplastic columnar epithelium in the distal oesophagus which replaces normal squamous epithelium and which predisposes to cancer development. It is this second requirement, the predisposition to cancer, which makes this condition both clinically highly relevant and an important area for ongoing research. While BE has been defined pathologically since the 1950's (Allison and Johnstone, Thorax 1955), and identified as a risk factor for esophageal adenocarcinoma since the 1970's (Naef A...
February 2015: Best Practice & Research. Clinical Gastroenterology
K Nadine Phoa, Roos E Pouw, Raf Bisschops, Oliver Pech, Krish Ragunath, Bas L A M Weusten, Brigitte Schumacher, Bjorn Rembacken, Alexander Meining, Helmut Messmann, Erik J Schoon, Liebwin Gossner, Jayan Mannath, C A Seldenrijk, Mike Visser, Toni Lerut, Stefan Seewald, Fiebo J ten Kate, Christian Ell, Horst Neuhaus, Jacques J G H M Bergman
OBJECTIVE: Focal endoscopic resection (ER) followed by radiofrequency ablation (RFA) safely and effectively eradicates Barrett's oesophagus (BO) containing high-grade dysplasia (HGD) and/or early cancer (EC) in smaller studies with limited follow-up. Herein, we report long-term outcomes of combined ER and RFA for BO (HGD and/or EC) from a single-arm multicentre interventional study. DESIGN: In 13 European centres, patients with BO ≤ 12 cm with HGD and/or EC on 2 separate endoscopies were eligible for inclusion...
April 2016: Gut
Kirill Pavlov, Judith Honing, Coby Meijer, Wytske Boersma-van Ek, Frans T M Peters, Anke van den Berg, Arend Karrenbeld, John T M Plukker, Frank A E Kruyt, Jan H Kleibeuker
BACKGROUND: Barrett's oesophagus can progress towards oesophageal adenocarcinoma through a metaplasia-dysplasia-carcinoma sequence, but the underlying mechanisms are poorly understood. The transcription factor GATA6 is known to be involved in columnar differentiation and proliferation, and GATA6 gene amplification was recently linked with poor survival in oesophageal adenocarcinoma. AIM: To study the expression of GATA6 during Barrett's oesophagus development and malignant transformation...
January 2015: Digestive and Liver Disease
M P Kumarasinghe, I Brown, S Raftopoulos, M J Bourke, A Charlton, W B de Boer, R Eckstein, K Epari, A J Gill, A K Lam, T Price, C Streutker, G Y Lauwers
Endoscopic resection (ER) is considered the therapy of choice for intraepithelial neoplasia associated with visible lesions and T1a adenocarcinoma. Pathologists are bound to encounter specimens collected via these techniques more frequently in their practice. A standardised protocol for handling, grossing, and assessing ER specimens should be adopted to ensure that all prognostic information and characteristics influencing treatment are included in reports (see Supplementary Video Abstract, http://links.lww...
October 2014: Pathology
David Al Dulaimi
Dong Y, Qi B, Feng XY, Jiang CM. Meta-analysis of Barrett's esophagus in China. World J Gastroenterol 2013;19(46):8770-8779 The disease pattern of Barrett's esophagus (BE) in China is poorly characterised particularly in comparison with other developed countries. This meta-analysis of 3873 cases of BE collated from 69 clinical studies conducted in 25 provinces between 2000 and 2011 investigated the epidemiology and characteristics of BE in China compared to Western countries. The total endoscopic detection rate of BE was 1...
2014: Gastroenterology and Hepatology From Bed to Bench
H Barr, C Kendall, N Stone
BACKGROUND: Barrett's oesophagus is the columnar-lined metaplasia that occurs in response to severe gastro-oesophageal reflux and accounts for the dramatic rise in adenocarcinoma at the gastro-oesophageal junction. DIAGNOSTIC METHODS: Endoscopic recognition and pathological diagnosis of the condition is fraught with erroneous interpretation of the pre-malignant degeneration of dysplasia. Screening and surveillance programmes have yet to impact on the disease. Photodiagnosis by spectroscopy and imaging is under intense investigation...
May 2004: Photodiagnosis and Photodynamic Therapy
Lucas C Duits, K Nadine Phoa, Wouter L Curvers, Fiebo J W Ten Kate, Gerrit A Meijer, Cees A Seldenrijk, G Johan Offerhaus, Mike Visser, Sybren L Meijer, Kausilia K Krishnadath, Jan G P Tijssen, Rosalie C Mallant-Hent, Jacques J G H M Bergman
OBJECTIVE: Reported malignant progression rates for low-grade dysplasia (LGD) in Barrett's oesophagus (BO) vary widely. Expert histological review of LGD is advised, but limited data are available on its clinical value. This retrospective cohort study aimed to determine the value of an expert pathology panel organised in the Dutch Barrett's Advisory Committee (BAC) by investigating the incidence rates of high-grade dysplasia (HGD) and oesophageal adenocarcinoma (OAC) after expert histological review of LGD...
May 2015: Gut
Melissa F Hale, Reena Sidhu, Mark E McAlindon
Capsule endoscopy (CE) has transformed investigation of the small bowel providing a non-invasive, well tolerated means of accurately visualising the distal duodenum, jejunum and ileum. Since the introduction of small bowel CE thirteen years ago a high volume of literature on indications, diagnostic yields and safety profile has been presented. Inclusion in national and international guidelines has placed small bowel capsule endoscopy at the forefront of investigation into suspected diseases of the small bowel...
June 28, 2014: World Journal of Gastroenterology: WJG
James L Corbett, David Tosh
Metaplasia is the irreversible conversion of one differentiated cell or tissue type into another. Metaplasia usually occurs in tissues that undergo regeneration, and may, in a pathological context, predispose to an increased risk of disease. Studying the conditions leading to the development of metaplasia is therefore of significant clinical interest. In contrast, transdifferentiation (or cellular reprogramming) is a subset of metaplasia that describes the permanent conversion of one differentiated cell type into another, and generally occurs between cells that arise from neighbouring regions of the same germ layer...
June 2014: Biochemical Society Transactions
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