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Barrett's esophagus pathology

M Q Chan, A E Blum, A K Chandar, A M L Kieber Emmons, Y Shindo, W Brock, G W Falk, M I Canto, J S Wang, P G Iyer, N J Shaheen, W M Grady, J A Abrams, P N Thota, K K Guda, A Chak
Barrett's esophagus (BE) is the only known precursor to esophageal adenocarcinoma (EAC). Based on striking aggregation of breast cancer and BE/EAC within families as well as shared risk factors and molecular mechanisms of carcinogenesis, we hypothesized that BE may be associated with breast cancer. Pedigree analysis of families identified prospectively at multiple academic centers as part of the Familial Barrett's Esophagus Consortium (FBEC) was reviewed and families with aggregation of BE/EAC and breast cancer are reported...
March 7, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Tuure Saarinen, Ulla Kettunen, Kirsi H Pietiläinen, Anne Juuti
BACKGROUND: Consensus on the necessity of esophagogastroduodenoscopy (EGD) before bariatric surgery is lacking. Recommendations and practices vary by country and unit. Several reports have expressed concerns on gastroesophageal reflux disease (GERD) and its consequences after sleeve gastrectomy (SG) and the risk of leaving a premalignant lesion in the excluded stomach after Roux-en-Y gastric bypass (RYGB). OBJECTIVES: We explored the number and types of clinically significant findings in preoperative EGDs and how they associate with preexisting GERD-symptoms (SG) and premalignant lesions (RYGB)...
February 14, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Syed H Haider, Sophia Kwon, Rachel Lam, Audrey K Lee, Erin J Caraher, George Crowley, Liqun Zhang, Theresa M Schwartz, Rachel Zeig-Owens, Mengling Liu, David J Prezant, Anna Nolan
Gastroesophageal reflux disease (GERD) and Barrett's Esophagus (BE), which are prevalent in the World Trade Center (WTC) exposed and general populations, negatively impact quality of life and cost of healthcare. GERD, a risk factor of BE, is linked to obstructive airways disease (OAD). We aim to identify serum biomarkers of GERD/BE, and assess the respiratory and clinical phenotype of a longitudinal cohort of never-smoking, male, WTC-exposed rescue workers presenting with pulmonary symptoms. Biomarkers collected soon after WTC-exposure were evaluated in optimized predictive models of GERD/BE...
February 15, 2018: Scientific Reports
Jes Sefland Vogt, Anders Christian Larsen, Thorbjørn Sommer, Per Ejstrud
OBJECTIVES: The aim of this study was to evaluate adherence to Barrett's esophagus (BE) surveillance guidelines in Denmark. METHODS: The Danish Pathology Registry was used to identify 3692 patients. A total of 300 patients were included by drawing a simple random sample. Description of the BE segment, biopsy protocol, communication with the pathologist and planned follow-up endoscopy, was evaluated. RESULTS: Thirty-one patients were excluded due to missing reports and 83 patients (28%) due to no endoscopic evidence of BE...
January 23, 2018: Scandinavian Journal of Gastroenterology
Fergus Chedgy, Carole Fogg, Kesavan Kandiah, Hugh Barr, Bernard Higgins, Mimi McCord, Ann Dewey, John De Caestecker, Lisa Gadeke, Clive Stokes, David Poller, Gaius Longcroft-Wheaton, Pradeep Bhandari
Background and study aims : Barrett's esophagus is a potentially pre-cancerous condition, affecting 375,000 people in the UK. Patients receive a 2-yearly endoscopy to detect cancerous changes, as early detection and treatment results in better outcomes. Current treatment requires random mapping biopsies along the length of Barrett's, in addition to biopsy of visible abnormalities. As only 13 % of pre-cancerous changes appear as visible nodules or abnormalities, areas of dysplasia are often missed...
January 2018: Endoscopy International Open
Sarmed S Sami, Prasad G Iyer
OPINION STATEMENT: PURPOSE OF REVIEW: There is a pressing need for effective strategies to halt the increase in both the incidence and mortality of esophageal adenocarcinoma (EAC). Screening for Barrett's esophagus, which is the only known precursor of EAC, remains a ripe area for research, particularly with regard to identifying the target population, screening tools, and management of screen-detected populations. This review aims to explore in depth the rationale for screening for Barrett's esophagus, recent biotechnological advances which may have the potential of making screening feasible, and also highlight the challenges which will have to be overcome in order make screening for BE a realistic prospect...
March 2018: Current Treatment Options in Gastroenterology
José M García-Heredia, Amancio Carnero
Inflammation is a complex defensive response activated after various harmful stimuli allowing the clearance of damaged cells and initiating healing and regenerative processes. Chronic, or pathological, inflammation is also one of the causes of neoplastic transformation and cancer development. MAP17 is a cargo protein that transports membrane proteins from the endoplasmic reticulum. Therefore, its overexpression may be linked to an excess of membrane proteins that may be recognized as an unwanted signal, triggering local inflammation...
November 17, 2017: Oncotarget
Marcela A Salomao, Dora Lam-Himlin, Rish K Pai
The pathologic diagnosis of dysplasia in Barrett esophagus (BE) suffers from interobserver disagreement. Many of the studies demonstrating disagreement in the diagnosis of dysplasia have pathologists review individual biopsy slides in isolation. To more closely mimic daily practice, 3 pathologists reviewed hematoxylin and eosin slides made from 549 individual biopsy jars obtained from 129 unique patients with a diagnosis of BE. Each pathologist reviewed the entirety of a given patient's biopsy material. The grade of dysplasia present in each biopsy jar was given as well as an overall highest grade of dysplasia from the patient's entire set of biopsies...
March 2018: American Journal of Surgical Pathology
Xiangqing Sun, Apoorva K Chandar, Marcia I Canto, Prashanthi N Thota, Malcom Brock, Nicholas J Shaheen, David G Beer, Jean S Wang, Gary W Falk, Prasad G Iyer, Julian A Abrams, Medha Venkat-Ramani, Martina Veigl, Alexander Miron, Joseph Willis, Deepa T Patil, Ilke Nalbantoglu, Kishore Guda, Sanford D Markowitz, Xiaofeng Zhu, Robert Elston, Amitabh Chak
BACKGROUND: Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) are far more prevalent in European Americans than in African Americans. Hypothesizing that this racial disparity in prevalence might represent a genetic susceptibility, we used an admixture mapping approach to interrogate disease association with genomic differences between European and African ancestry. METHODS: Formalin fixed paraffin embedded samples were identified from 54 African Americans with BE or EAC through review of surgical pathology databases at participating Barrett's Esophagus Translational Research Network (BETRNet) institutions...
2017: PloS One
C G Bremner, T R Demeester
The increasing incidence of adenocarcinoma of the lower esophagus and cardia arising in Barrett's metaplastic epithelium continues to be of great concern because medical and surgical efforts to reverse the process have been disappointing. A potential answer to the problem is removal of the metaplastic epithelium. Modern technology has introduced physical and chemical modalities which facilitate ablation of the neo-epithelium endoscopically. These techniques have been used in several centers, and preliminary results are encouraging...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
James K Chambers, Tsubasa Saito, Kenjiro Fukushima, Shigeru Kakuta, Jun Nakayama, Koichi Ohno, Hajime Tsujimoto, Hiroyuki Nakayama, Kazuyuki Uchida
An endoscopic examination revealed a mass in the distal esophagus of a 9-year-old intact male bulldog. Histopathologically, the mass was composed of cuboidal to columnar neoplastic epithelial cells and extended from the squamous epithelium of the esophageal mucosa, indicating that the tumor was derived from Barrett's esophagus. Moreover, highly atypical foci that exhibited a cribriform pattern and high mitotic indices were also observed. The epithelial cells on the surface of the lesion often produced mucus that was positive for Alcian blue and immunohistochemically positive for MUC5AC...
July 2017: Journal of Toxicologic Pathology
Marcia Irene Canto, Julian A Abrams, Hannah T Künzli, Bas Weusten, Yoshihiro Komatsu, Blair A Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by EMR, endoscopic submucosal dissection (ESD), or radiofrequency ablation. A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system [CbFAS]) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 16, 2017: Gastrointestinal Endoscopy
J L Herrera Elizondo, R Monreal Robles, D García Compean, E I González Moreno, O D Borjas Almaguer, H J Maldonado Garza, J A González González
INTRODUCTION AND AIMS: Barrett's esophagus is a condition that predisposes to esophageal adenocarcinoma. Our aim was to establish the prevalence of Barrett's esophagus at our center, as well as determine its associated factors. MATERIALS AND METHODS: We retrospectively assessed the endoscopic reports of 500 outpatients seen at our Gastroenterology Service from November 2014 to April 2016. We determined the prevalence of Barrett's esophagus and analyzed the demographic, clinical, and endoscopic findings associated with that pathology...
July 4, 2017: Revista de Gastroenterología de México
F Valdovinos-Andraca, A R Bernal-Méndez, R Barreto-Zúñiga, D Briseño-García, J A Martínez-Lozano, A F Romano-Munive, J Elizondo-Rivera, F I Téllez-Ávila
INTRODUCTION: The prevalence of Barrett's esophagus has been calculated at between 1.3 and 1.6%. There is little information with respect to this in Mexico. AIM: To determine the frequency and characteristics of Barrett's esophagus in patients that underwent endoscopy at a national referral center, within a 10-year time frame. MATERIAL AND METHODS: The databases of the pathology and gastrointestinal endoscopy departments of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" were analyzed, covering the period of January 2002 to December 2012...
May 24, 2017: Revista de Gastroenterología de México
Benjamin Michael Allanson, Jessica Bonavita, Bob Mirzai, Tze Sheng Khor, Spiro C Raftopoulos, Willem Bastiaan de Boer, Ian S Brown, Marian Priyanthi Kumarasinghe
The assumption that intestinal metaplasia is a prerequisite for intraepithelial neoplasia/dysplasia and adenocarcinoma in the distal esophagus has been challenged by observations of adenocarcinoma without associated intestinal metaplasia. This study describes our experience of intestinal metaplasia in association with early Barrett neoplasia in distal esophagus and gastroesophageal junction. We reviewed the first endoscopic mucosal resection of 139 patients with biopsy-proven neoplasia. In index endoscopic mucosal resection, 110/139 (79%) cases showed intestinal metaplasia...
August 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Shilpa Jain, Sadhna Dhingra
Esophageal cancer is a serious malignancy with high mortality. The two common distinctive pathologic subtypes of esophageal cancer are squamous cell carcinoma and adenocarcinoma. These differ with regards to etiology, ethnic distribution, pathogenesis, and location in the esophagus. The precursor lesions are also unique to each subtype. Squamous cell carcinoma is more common in East Asia, is linked to smoking and tobacco use, more commonly involves the middle esophagus, and the precursor lesion is squamous dysplasia...
March 2017: Annals of Cardiothoracic Surgery
Yoshiko Nakayama, Shinobu Ida
Esophagogastric landmarks are recognizable in the same way both in children and in adults, and palisade-shaped vessels can be observed at the distal position of esophageal mucosa, even in infants. Few studies have been done in respect to Barrett's esophagus (BE) in children. Incidence of endoscopically suspected BE among all children undergoing esophagogastroduodenoscopy (EGD) is approximately 0.25-1.4%, but can be up to 9.7% in patients with gastroesophageal reflux disease (GERD). Some data suggest that BE is an acquired disorder and point to the possibility of a congenital component in combination with severe mucosal injury...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Chao Li, Denise Tami Yamashita, Jeffrey David Hawel, Drew Bethune, Harry Henteleff, James Ellsmere
BACKGROUND: Esophagectomy has been the standard of care for patients with intramucosal adenocarcinoma (IMC) in the setting of Barrett's esophagus. It is, however, associated with significant post-operative morbidity and mortality. Endoscopic mucosal resection (EMR) offers a minimally invasive approach with lesser morbidity. This study investigates the transition from esophagectomy to EMR for IMC with respect to eradication rates, post-operative morbidity, and long-term survival. METHODS: Patients diagnosed with IMC from 2005 to 2013 were identified retrospectively...
October 2017: Surgical Endoscopy
Nicole C Panarelli, Rhonda K Yantiss
PURPOSE OF REVIEW: To summarize the literature regarding appropriate endoscopic sampling and surveillance protocols for common inflammatory diseases of the digestive tract. Gastroenterologists increasingly use endoscopy with mucosal biopsy to detect inflammatory diseases, assess response to therapy, and monitor for progression to dysplasia. RECENT FINDINGS: Many diseases show a patchy distribution in the digestive tract and there may be poor correlation between the endoscopic appearance and presence of histologic abnormalities...
September 2016: Current Opinion in Gastroenterology
Shivali Marketkar, Dan Li, Dongfang Yang, Weibiao Cao
AIM: To examined the bile acid receptor TGR5 expression in squamous mucosa, Barrett's mucosa, dysplasia and esophageal adenocarcinoma (EA). METHODS: Slides were stained with TGR5 antibody. The staining intensity was scored as 1+, 2+ and 3+. The extent of staining (percentage of cells staining) was scored as follows: 1+, 1%-10%, 2+, 11%-50%, 3+, 51%-100%. A combined score of intensity and extent was calculated and categorized as negative, weak, moderate and strong staining...
February 28, 2017: World Journal of Gastroenterology: WJG
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