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Barrett's esophagus pathology

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https://www.readbyqxmd.com/read/28026198/the-importance-of-a-second-opinion-in-the-diagnosis-of-barrett-s-esophagus-a-real-life-study
#1
Vincenzo Villanacci, Marianna Salemme, Italo Stroppa, Valerio Balassone, Gabrio Bassotti
BACKGROUND: Barrett's esophagus is a precancerous lesion, and its identification with the early detection of dysplasia is of paramount importance to prevent adenocarcinoma onset. However, there is still debate on the correct pathological identification of Barrett's esophagus (and of associated dysplasia), and most studies have been conducted in an experimental setting. AIMS: To assess previous uncertain diagnoses of Barrett's (with and without dysplasia) via a second opinion of an expert pathologist in a real life setting...
December 27, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27997963/efficacy-of-the-cryoballoon-focal-ablation-system-for-the-eradication-of-dysplastic-barrett-s-esophagus-islands
#2
Hannah T Künzli, Dirk W Schölvinck, Sybren L Meijer, Kees A Seldenrijk, Jacques G H M Bergman, Bas L A M Weusten
Background and study aim Cryoablation can be used for the treatment of Barrett's esophagus (BE). A recent dosimetry study, using the CryoBalloon Focal Ablation System (CryoBalloon), demonstrated that 10-second ablations result in complete eradication of BE. However, the efficacy of 10-second ablation in a larger cohort of patients has not been investigated, nor has the potential of precise targeting of specific areas. The aim of the study was to assess the efficacy and performance (i. e. targeting of BE islands) of a 10-second cryoablation using the CryoBalloon...
December 20, 2016: Endoscopy
https://www.readbyqxmd.com/read/27984396/current-endoscopic-approaches-for-the-treatment-of-barrett-esophagus
#3
Bryan Brimhall, Sachin Wani
Barrett esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC), a cancer associated with a poor 5-year survival rate. The stepwise pathologic progression of BE to invasive cancer provides an opportunity to halt progression and potentially decrease incidence and ultimately the morbidity and mortality related to this lethal cancer. Endoscopic eradication therapy (EET) in patients at increased risk of progression to invasive EAC (intramucosal EAC, high-grade dysplasia, and low-grade dysplasia) is a practice that is endorsed by multiple societies and has replaced esophagectomy as the standard of care for these patients...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27941583/current-endoscopic-approaches-for-the-treatment-of-barrett-esophagus
#4
Bryan Brimhall, Sachin Wani
Barrett esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC), a cancer associated with a poor 5-year survival rate. The stepwise pathologic progression of BE to invasive cancer provides an opportunity to halt progression and potentially decrease incidence and ultimately the morbidity and mortality related to this lethal cancer. Endoscopic eradication therapy (EET) in patients at increased risk of progression to invasive EAC (intramucosal EAC, high-grade dysplasia, and low-grade dysplasia) is a practice that is endorsed by multiple societies and has replaced esophagectomy as the standard of care for these patients...
January 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27889544/role-of-eus-in-patients-with-suspected-barrett-s-esophagus-with-high-grade-dysplasia-or-early-esophageal-adenocarcinoma-impact-on-endoscopic-therapy
#5
Michael J Bartel, Timothy M Wallace, Rene D Gomez-Esquivel, Massimo Raimondo, Herbert C Wolfsen, Timothy A Woodward, Michael B Wallace
BACKGROUND AND AIMS: Endoscopic therapy is the standard treatment for high-grade dysplasia and some cases of T1a esophageal adenocarcinoma (EAC), but it is not appropriate for deeply invasive disease. Data on the value of EUS for patient selection for endoscopic or surgical resection are conflicting. We investigated the outcome of esophageal EUS for the staging and treatment selection of patients with treatment-naive, premalignant Barrett's esophagus (BE) and suspected superficial EAC...
November 24, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27882742/esophageal-adenocarcinoma-and-barrett-esophagus-in-a-neurologically-impaired-teenager
#6
Jae-Yeon Hwang, Yeoun Joo Lee, Peter Chun, Dong Hoon Shin, Jae Hong Park
Esophageal adenocarcinoma (EAC) accompanied by Barrett esophagus (BE) is rare in patients younger than 20 years old. EAC in the upper esophagus is also rare. We report a rare case of EAC with BE that developed in the upper esophagus after chronic, untreated gastroesophageal reflux disease in a neurologically impaired teenager. A 19-year-old neurologically impaired man underwent endoscopy for evaluation of dysphagia and vomiting, and was diagnosed with EAC with BE. He underwent transthoracic esophagectomy, extensive lymph node dissection, and cervical esophagogastric anastomosis, but the prognosis was poor...
November 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27864719/routine-staging-with-endoscopic-ultrasound-in-patients-with-obstructing-esophageal-cancer-and-dysphagia-rarely-impacts-treatment-decisions
#7
Sara A Mansfield, Samer El-Dika, Somashekar G Krishna, Kyle A Perry, Jon P Walker
BACKGROUND: Endoscopic ultrasound (EUS) has been routinely utilized for the locoregional staging of esophageal cancer. One important aspect of clinical staging has been to stratify patients to treatment with neoadjuvant chemoradiation or primary surgical therapy. We hypothesized that EUS may have a limited impact on clinical decision making in patients with dysphagia and obstructing esophageal masses. METHODS: This retrospective cohort study included all patients with esophageal adenocarcinoma undergoing esophageal EUS between July 2008 and September 2013...
November 18, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27855466/detection-of-lesions-in-dysplastic-barrett-s-esophagus-by-community-and-expert-endoscopists
#8
Dirk W Schölvinck, Kim van der Meulen, Jacques J G H M Bergman, Bas L A M Weusten
Background and aims: Endoscopic treatment of Barrett's esophagus (BE) consists of endoscopic resection of visible lesions followed by radiofrequency ablation (RFA) for any remaining flat BE. Because RFA is only justified in flat BE, detection of neoplastic lesions (high grade dysplasia [HGD] and early adenocarcinoma [EAC]) is crucial. We hypothesized that the detection of visible lesions containing HGD or EAC would be superior in BE expert centers compared with community hospitals, thereby supporting centralization of therapy for BE-related neoplasia...
November 17, 2016: Endoscopy
https://www.readbyqxmd.com/read/27812392/periesophageal-pseudoaneurysms-rare-cause-of-refractory-bleeding-treated-with-transarterial-embolization
#9
Divyanshoo R Kohli, Rachit D Shah, Daniel J Komorowski, George B Smallfield
A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27735829/long-term-efficacy-of-laparoscopic-antireflux-surgery-on-regression-of-barrett-s-esophagus-using-bravo-wireless-ph-monitoring-a-prospective-clinical-cohort-study
#10
Benjamin C Knight, Peter G Devitt, David I Watson, Lorelle T Smith, Glyn G Jamieson, Sarah K Thompson
OBJECTIVE: To assess the long-term efficacy of antireflux surgery on Barrett's esophagus (BE) using BRAVO wireless pH monitoring. BACKGROUND: BE is associated with chronic gastroesophageal reflux and esophageal cancer. Till date, studies have failed to demonstrate that preventing gastroesophageal reflux with antireflux surgery halts the progression of BE, often because of difficulties in objectively proving an effective antireflux barrier. METHODS: Since 1991, all patients undergoing antireflux surgery across 2 hospital sites have been followed in a prospective database...
October 4, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27729357/a-tissue-systems-pathology-test-detects-abnormalities-associated-with-prevalent-high-grade-dysplasia-and-esophageal-cancer-in-barrett-s-esophagus
#11
Rebecca J Critchley-Thorne, Jon M Davison, Jeffrey W Prichard, Lia M Reese, Yi Zhang, Kathleen A Repa, Jinhong Li, David L Diehl, Nirag C Jhala, Gregory Ginsberg, Maureen DeMarshall, Tyler Foxwell, Blair A Jobe, Ali H Zaidi, Lucas C Duits, Jacques J G H M Bergman, Anil K Rustgi, Gary W Falk
BACKGROUND: There is a need for improved tools to detect high grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus (BE). In previous work, we demonstrated that a 3-tier classifier predicted risk of incident progression in BE. Our aim was to determine if this risk classifier could detect a field effect in non-dysplastic (ND), indefinite for dysplasia (IND) or low-grade dysplasia (LGD) biopsies from BE patients with prevalent HGD/EAC. METHODS: We performed a multi-institutional case-control study to evaluate a previously developed risk classifier that is based upon quantitative image features derived from 9 biomarkers and morphology, and predicts risk for HGD/EAC in BE patients...
October 11, 2016: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/27703114/sex-and-gender-differences-in-gastroesophageal-reflux-disease
#12
Young Sun Kim, Nayoung Kim, Gwang Ha Kim
It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s...
October 30, 2016: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/27573770/definition-derivation-and-diagnosis-of-barrett-s-esophagus-pathological-perspectives
#13
H Lowes, T Somarathna, Neil A Shepherd
More than 60 years have elapsed since Barrett described the condition that continues to bear his name. Despite much research, clinical and basic, the defining features and the diagnosis of columnar-lined esophagus (CLO) are still embroiled with controversy and uncertainty. For pathologists, these controversies are notorious. The disease has been defined by the pathological demonstration of "specialized intestinal metaplasia" and yet there is compelling evidence that this approach is flawed due to sampling issues, poor levels of agreement between expert pathologists as to what constitutes "goblet cells," and the fact that most glandular epithelium in the esophagus is "intestinalized," even if goblet cells are not demonstrable...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27556083/prospective-evaluation-of-the-clinical-utility-of-endoscopic-submucosal-dissection-esd-in-patients-with-barrett-s-esophagus-a-western-center-experience
#14
Roxana M Coman, Takuji Gotoda, Christopher E Forsmark, Peter V Draganov
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) carries significant advantages over endoscopic mucosal resection. As such, ESD is an established therapy for esophageal squamous cell carcinoma but there are only limited data on ESD as therapy for Barrett's esophagus (BE). Thus, we prospectively evaluated the outcomes of ESD in patients with BE with high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) performed in a Western center. PATIENTS AND METHODS: This is a prospective cohort study...
June 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27541368/esophagectomy-as-a-treatment-consideration-for-early-stage-esophageal-cancer-and-high-grade-dysplasia
#15
Patrick J McLaren, James P Dolan
In recent years, a number of endoluminal procedures such as endoscopic resection and thermal ablation have emerged as less invasive treatment options for early esophageal cancer. These therapies have demonstrated excellent oncologic outcomes for dysplasia as well as intramucosal cancers. However, few studies have directly compared long-term outcomes of endoscopic therapy versus traditional esophagectomy. Current esophagectomy techniques now deliver consistently good outcomes in the hands of experienced surgeons at high volume centers, and this option should be considered an important treatment consideration for early esophageal cancer...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27470391/differential-role-of-micrornas-in-the-pathogenesis-and-treatment-of-esophageal-cancer
#16
REVIEW
Maryam Hemmatzadeh, Hamed Mohammadi, Mohammad Karimi, Mohammad Hossein Musavishenas, Behzad Baradaran
Esophageal cancer (EC) is the most invasive disease associated with inclusive poor prognosis. EC usually is found as either adenocarcinoma (EAC) or squamous cell carcinomas (ESCC). ESCC forms in squamous cells and highly occurs in the upper third of the esophagus. EAC appears in glandular cells and ordinarily develops in the lower one third of the esophagus near the stomach. Barrett's esophagus (BE) is a metaplastic precursor of EAC. There is a persistent need for improving our understanding of the molecular basis of this disease...
August 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27446850/diagnosis-and-management-of-barrett-s-esophagus-a-retrospective-study-comparing-the-endoscopic-assessment-of-early-esophageal-lesions-in-the-community-versus-a-specialized-center
#17
Erin Rayner-Hartley, Oliver Takach, Cherry Galorport, Robert A Enns
Specialized endoscopic evaluation for patients with Barrett's esophagus (BE) is well supported; however, no studies have shown that centers with expertise provide better quality care for BE with high-grade dysplasia or early adenocarcinoma. In this study, the investigators aimed to evaluate the management and clinical course for patients treated in a community practice versus a specialized BE center. Methods. A retrospective analysis of referrals from the community to our specialized center for evaluation of BE at St Paul's Hospital Division of Gastroenterology between January 2007 and February 2014 was performed...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27441783/contribution-of-immunomodulators-to-gastroesophageal-reflux-disease-and-its-complications-stromal-cells-interleukin-4-and-adiponectin
#18
Jing Li, Xiaoxin Luke Chen, Anisa Shaker, Tadayuki Oshima, Jing Shan, Hiroto Miwa, Cheng Feng, Jun Zhang
Gastroesophageal reflux disease (GERD) has become the most commonly seen gastrointestinal disorder in outpatient clinics. In the United States, around 20% of the general population experience heartburn on a weekly basis. Although clinical complaints can be mild or moderate, patients with GERD may develop further complications, such as peptic strictures, Barrett's esophagus (BE), and even esophageal adenocarcinoma. Pathologically, GERD is developed as a result of chronic and enhanced exposure of the esophageal epithelium to noxious gastric refluxate...
September 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27415419/the-esophageal-microbiota-in-health-and-disease
#19
Vincenzo Di Pilato, Giancarlo Freschi, Maria Novella Ringressi, Lucia Pallecchi, Gian Maria Rossolini, Paolo Bechi
The esophageal mucosa is among the sites colonized by human microbiota, the complex microbial ecosystem that colonizes various body surfaces and is increasingly recognized to play roles in several physiological and pathological processes. Our understanding of the composition of the esophageal microbiota in health and disease is challenged by the need for invasive sampling procedures and by the dynamic nature of the esophageal environment and remains limited in comparison with the information available for other body sites...
July 14, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27197290/a-tissue-systems-pathology-assay-for-high-risk-barrett-s-esophagus
#20
Rebecca J Critchley-Thorne, Lucas C Duits, Jeffrey W Prichard, Jon M Davison, Blair A Jobe, Bruce B Campbell, Yi Zhang, Kathleen A Repa, Lia M Reese, Jinhong Li, David L Diehl, Nirag C Jhala, Gregory Ginsberg, Maureen DeMarshall, Tyler Foxwell, Ali H Zaidi, D Lansing Taylor, Anil K Rustgi, Jacques J G H M Bergman, Gary W Falk
BACKGROUND: Better methods are needed to predict risk of progression for Barrett's esophagus. We aimed to determine whether a tissue systems pathology approach could predict progression in patients with nondysplastic Barrett's esophagus, indefinite for dysplasia, or low-grade dysplasia. METHODS: We performed a nested case-control study to develop and validate a test that predicts progression of Barrett's esophagus to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC), based upon quantification of epithelial and stromal variables in baseline biopsies...
June 2016: Cancer Epidemiology, Biomarkers & Prevention
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