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barrett's esophagus diagnosis

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https://www.readbyqxmd.com/read/27899321/volumetric-laser-endomicroscopy-in-barrett-s-esophagus-interobserver-agreement-for-interpretation-of-barrett-s-esophagus-and-associated-neoplasia-among-high-frequency-users
#1
Arvind J Trindade, Sumant Inamdar, Michael S Smith, Kenneth J Chang, Cadman L Leggett, Charles J Lightdale, Douglas K Pleskow, Divyesh V Sejpal, Guillermo J Tearney, Rebecca M Thomas, Michael B Wallace
BACKGROUND AND AIMS: Targeting neoplasia in Barrett's esophagus (BE) is challenging. Volumetric laser endomicroscopy (VLE) is a new imaging technique that allows for real time cross-sectional microstructure imaging that can detect BE neoplasia. The interobserver agreement among users in practice is unknown. METHODS: Eight high-volume users of VLE from different academic centers in the United States evaluated 120-stored VLE images blinded to the endoscopic and clinical findings...
November 26, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27893678/value-of-cyclin-a-immunohistochemistry-for-cancer-risk-stratification-in-barrett-esophagus-surveillance-a-multicenter-case-control-study
#2
Sophie H van Olphen, Fiebo J C Ten Kate, Michail Doukas, Florine Kastelein, Ewout W Steyerberg, Hans A Stoop, Manon C Spaander, Leendert H J Looijenga, Marco J Bruno, Katharina Biermann
The value of endoscopic Barrett esophagus (BE) surveillance based on histological diagnosis of low-grade dysplasia (LGD) remains debated given the lack of adequate risk stratification. The aim of this study was to evaluate the predictive value of cyclin A expression and to combine these results with our previously reported immunohistochemical p53, AMACR, and SOX2 data, to identify a panel of biomarkers predicting neoplastic progression in BE.We conducted a case-control study within a prospective cohort of 720 BE patients...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27889544/the-role-of-eus-in-patients-with-suspected-barrett-s-esophagus-with-high-grade-dysplasia-or-early-esophageal-adenocarcinoma-impact-on-endoscopic-therapy
#3
Michael J Bartel, Timothy Wallace, Rene Gomez, 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-naïve, premalignant Barrett's esophagus (BE) and suspected superficial EAC...
November 23, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27864719/routine-staging-with-endoscopic-ultrasound-in-patients-with-obstructing-esophageal-cancer-and-dysphagia-rarely-impacts-treatment-decisions
#4
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/27862680/the-natural-history-of-gastro-esophageal-reflux-disease-a-comprehensive-review
#5
REVIEW
E Savarino, N de Bortoli, C De Cassan, M Della Coletta, O Bartolo, M Furnari, A Ottonello, E Marabotto, G Bodini, V Savarino
Gastroesophageal reflux disease (GERD) is a common disorder of the upper gastrointestinal tract which is typically characterized by heartburn and acid regurgitation. These symptoms are widespread in the community and range from 2.5% to more than 25%. Economic analyses showed an increase in direct and indirect costs related to the diagnosis, treatment and surveillance of GERD and its complications. The aim of this review is to provide current information regarding the natural history of GERD, taking into account the evolution of its definition and the worldwide gradual change of its epidemiology...
November 9, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27861759/metabolic-syndrome-and-risk-of-esophageal-adenocarcinoma-in-elderly-patients-in-the-united-states-an-analysis-of-seer-medicare-data
#6
Jennifer Drahos, Winnie Ricker, Ruth M Pfeiffer, Michael B Cook
BACKGROUND: Metabolic syndrome (MetS) is associated with cancer risk and increases the risk of Barrett esophagus, which is the precursor lesion of esophageal adenocarcinoma (EA), primarily in the absence of gastroesophageal reflux disease (GERD). However, to the authors' knowledge, little is known regarding whether MetS is associated with the risk of EA. METHODS: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database, the authors evaluated whether MetS was associated with EA...
November 8, 2016: Cancer
https://www.readbyqxmd.com/read/27855466/detection-of-lesions-in-dysplastic-barrett-s-esophagus-by-community-and-expert-endoscopists
#7
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/27842547/health-related-quality-of-life-in-patients-with-barrett-s-esophagus
#8
Chi-Yang Chang, Lukas Jyuhn-Hsiarn Lee, Jung-Der Wang, Ching-Tai Lee, Chi-Ming Tai, Tao-Qian Tang, Jaw-Town Lin
BACKGROUND: Gastroesophageal reflux disease (GERD) has become a major health problem globally, affecting patients' health-related quality of life (HRQOL). Barrett's esophagus (BE) is a precancerous lesion associated with GERD. BE patients might not only suffer from HRQOL losses by GERD but also face psychological distress due to the increased risk of developing cancer. However, the majority of patients in Asia have shorter BE segment which is different from the West. This study aimed to determine whether the HRQOL in BE patients were worse than in healthy referents in Taiwan...
November 14, 2016: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/27818599/progression-from-low-grade-dysplasia-to-malignancy-in-patients-with-barrett-s-esophagus-diagnosed-by-two-or-more-pathologists
#9
Harsha Moole, Jaymon Patel, Zohair Ahmed, Abhiram Duvvuri, Sreekar Vennelaganti, Vishnu Moole, Sowmya Dharmapuri, Raghuveer Boddireddy, Pratyusha Yedama, Naveen Bondalapati, Achuta Uppu, Prashanth Vennelaganti, Srinivas Puli
AIM: To evaluate annual incidence of low grade dysplasia (LGD) progression to high grade dysplasia (HGD) and/or esophageal adenocarcinoma (EAC) when diagnosis was made by two or more expert pathologists. METHODS: Studies evaluating the progression of LGD to HGD or EAC were included. The diagnosis of LGD must be made by consensus of two or more expert gastrointestinal pathologists. Articles were searched in Medline, Pubmed, and Embase. Pooled proportions were calculated using fixed and random effects model...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27818167/discordance-among-pathologists-in-the-united-states-and-europe-in-diagnosis-of-low-grade-dysplasia-for-patients-with-barrett-s-esophagus
#10
Prashanth Vennalaganti, Vijay Kanakadandi, John R Goldblum, Sharad C Mathur, Deepa T Patil, G Johan Offerhaus, Sybren L Meijer, Michael Vieth, Robert D Odze, Shreyas Saligram, Sravanthi Parasa, Neil Gupta, Alessandro Repici, Ajay Bansal, Mohammad Titi, Prateek Sharma
BACKGROUND & AIMS: There is sub-optimal inter-observer agreement, even among expert gastrointestinal pathologists, in the diagnosis of low-grade dysplasia (LGD) in patients with Barrett's esophagus (BE). We analyzed histopathological criteria required for a diagnosis of LGD using the new subcategories of LGD with inflammatory and dysplastic features. We categorized each diagnosis based on the level of confidence and assessed inter-observer agreement among gastrointestinal pathologists from 5 tertiary centers in the United States (US) and Europe...
November 3, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27747281/first-reports-of-esophageal-adenocarcinoma-with-white-globe-appearance-in-japanese-and-caucasian-patients
#11
Yusuke Tonai, Ryu Ishihara, Yasushi Yamasaki, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Yasuhiko Tomita, Hiroyasu Iishi
Background and study aims: Better endoscopic diagnosis in case of Barrett's esophagus is still needed. White globe appearance (WGA) is a novel endoscopic marker for gastric adenocarcinoma, with high sensitivity for differentiating between gastric cancer/high-grade dysplasia and other lesions. We report 2 cases of esophageal adenocarcinoma with WGA. In Case 1, esophagogastroduodenoscopy (EGD) revealed a 10-mm esophageal adenocarcinoma in a 48-year-old Japanese woman with short-segment Barrett's esophagus. A small (< 1 mm) white globular lesion, typical of WGA, was observed under the epithelium by magnifying narrow-band imaging...
October 2016: Endoscopy International Open
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
#12
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/27708506/barrett-s-esophagus-lessons-from-recent-clinical-trials
#13
Daniela Golger, Andreas Probst, Helmut Messmann
Data from recent studies cast doubt on former recommendations on diagnosis and management of Barrett's esophagus. Based on latest research findings several Gastroenterological Associations actualized their guidelines and international experts compiled consensus statements as practical help for clinicians. In this review we discuss recent trials and their impact on clinical practice, current recommendations and persisting controversies in Barrett's esophagus.
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/27702561/diagnosis-and-management-of-low-grade-dysplasia-in-barrett-s%C3%A2-esophagus-clinical-practice-updates-expert-review%C3%A2-from-the-clinical-guidelines-committee-of-the-american%C3%A2-gastroenterological-association
#14
Sachin Wani, Joel H Rubenstein, Michael Vieth, Jacques Bergman
The purpose of this clinical practice update: expert review is to define the key principles in the diagnosis and management of low-grade dysplasia (LGD) in Barrett's esophagus patients. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). Practice Advice 1: The extent of Barrett's esophagus should be defined using a standardized grading system documenting the circumferential and maximal extent of the columnar lined esophagus (Prague classification) with a clear description of landmarks and visible lesions (nodularity, ulceration) when present...
October 1, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27681220/novel-insights-into-esophageal-diagnostic-procedures
#15
Edoardo Savarino, Andrea Ottonello, Salvatore Tolone, Ottavia Bartolo, Myong Ki Baeg, Farhood Farjah, Shiko Kuribayashi, Katerina P Shetler, Christian Lottrup, Ellen Stein
The 21st century offers new advances in diagnostic procedures and protocols in the management of esophageal diseases. This review highlights the most recent advances in esophageal diagnostic technologies, including clinical applications of novel endoscopic devices, such as ultrathin endoscopy and confocal laser endomicroscopy for diagnosis and management of Barrett's esophagus; novel parameters and protocols in high-resolution esophageal manometry for the identification and better classification of motility abnormalities; innovative connections between esophageal motility disorder diagnosis and detection of gastroesophageal reflux disease (GERD); impedance-pH testing for detecting the various GERD phenotypes; performance of distensibility testing for better pathophysiological knowledge of the esophagus and other gastrointestinal abnormalities; and a modern view of positron emission tomography scanning in metastatic disease detection in the era of accountability as a model for examining other new technologies...
September 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27672300/trajectories-of-endoscopic-barrett-esophagus-chronological-changes-in-a-community-based-cohort
#16
Shouji Shimoyama, Toshihisa Ogawa, Toshiyuki Toma
AIM: To elucidate longitudinal changes of an endoscopic Barrett esophagus (BE), especially of short segment endoscopic BE (SSBE). METHODS: This study comprised 779 patients who underwent two or more endoscopies between January 2009 and December 2015. The intervals between the first and the last endoscopy were at least 6 mo. The diagnosis of endoscopic BE was based on the criteria proposed by the Japan Esophageal Society and was classified as long segment (LSBE) and SSBE, the latter being further divided into partial and circumferential types...
September 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27636715/large-area-spectrally-encoded-confocal-endomicroscopy-of-the-human-esophagus-in-vivo
#17
Dongkyun Kang, Simon C Schlachter, Robert W Carruth, Minkyu Kim, Tao Wu, Nima Tabatabaei, Amna R Soomro, Catriona N Grant, Mireille Rosenberg, Norman S Nishioka, Guillermo J Tearney
BACKGROUND AND OBJECTIVE: Diagnosis of esophageal diseases is often hampered by sampling errors that are inherent in endoscopic biopsy, the standard of care. Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal endomicroscopy technology that has the potential to visualize cellular features from large regions of the esophagus, greatly decreasing the likelihood of sampling error. In this paper, we report results from a pilot clinical study imaging the human esophagus in vivo with a prototype SECM endoscopic probe...
September 16, 2016: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/27616661/epidemiology-of-barrett-s-esophagus-and-esophageal-adenocarcinoma-in-spain-a-unicentric-study
#18
Quetzalihuitl Arroyo-Martínez, Manuel Rodríguez-Téllez, Antonio García-Escudero, Javier Brugal-Medina, Ricardo González-Cámpora, Ángel Caunedo Álvarez
INTRODUCTION: Barrett's esophagus (BE) is an acquired disease defined by the presence of intestinal metaplasia with goblet cells in the distal esophagus. The prevalence of BE has increased dramatically over the last years. AIMS: The primary aims of the study were to analyze the characteristics of BE and esophageal adenocarcinoma (EAC) in a Spanish health district during a follow-up period. METHODOLOGY: Sociodemographic factors, alcohol consumption and cigarette smoking were analyzed...
October 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27590624/two-year-follow-up-period-showing-the-natural-history-of-a-superficial-esophageal-adenocarcinoma-arising-in-a-long-segment-of-barrett-s-esophagus
#19
Junya Oguma, Soji Ozawa, Akihito Kazuno, Miho Nitta, Yamato Ninomiya, Sakura Tomita
A 55-year-old woman experienced gastrointestinal dysfunction caused by scleroderma. An initial endoscopy revealed an erosive lesion in a long segment of Barrett's esophagus, and a biopsy led to a diagnosis of ectopic gastric mucosa. Two years later, an irregular, elevated tumor developed at the same site. This tumor was suspected of having invaded the submucosal layer. A second biopsy led to a diagnosis of adenocarcinoma. The patient subsequently underwent a thoracoscopic esophagectomy. The resected specimen revealed an invasive tumor front that had invaded the deep layer of a duplicated muscularis mucosae...
October 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27588293/reimbursement-in-endoscopy-how-can-new-procedures-be-implemented
#20
REVIEW
Michael-Holger Wilke, Markus Rathmayer
BACKGROUND: New procedures in endoscopy take time to be incorporated in the German diagnosis-related groups (DRG) system. Depending on the extent of innovation and the costs, several pathways are possible. METHODS: This article provides an overview of possible pathways to implement new procedures in the German DRG payment system. Additionally, we compare the results of 2 surveys on the system of New Diagnostic and Treatment Methods (Neue Untersuchungs- und Behandlungsmethoden; NUB)...
February 2016: Visceral Medicine
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