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barrett's esophagus diagnosis

Patrick Sven Plum, Arnulf Heinrich Hölscher, Kristin Pacheco Godoy, Henner Schmidt, Felix Berlth, Seung-Hun Chon, Hakan Alakus, Elfriede Bollschweiler
BACKGROUND: The aim of this retrospective study was to compare the prognosis of patients with esophageal cancer after non-curative endoscopic resection (ER) followed by esophagectomy (ER + S) with that of patients after primary surgery (PS). METHODS: Between 2000 and 2015, 287 patients had esophagectomy for T1 esophageal cancer. 81 of these patients underwent at least one ER in curative intention before surgery (7 squamous cell carcinomas, 74 adenocarcinomas)...
March 13, 2018: Surgical Endoscopy
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
T-W Chuang, S-C Chen, K-T Chen
AIMS: The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). METHODS: Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review...
July 2017: Acta Gastro-enterologica Belgica
M Harrison, J E Allen, V S Gorrepati, J M E López-Jamar, P Sharma
Barrett's esophagus progresses to esophageal adenocarcinoma in a stepwise histological fashion of no dysplasia, low grade dysplasia, high grade dysplasia and cancer. Hence the progression to cancer from various histological stages is different. Progression to cancer from low grade dysplasia is highly variable in the literature due to high inter-observer variability between pathologists in diagnosing it. Studies have shown the utility of having confirmation of low grade dysplasia by expert pathologists or documenting its persistence on two subsequent endoscopies in order to unify the diagnosis...
March 1, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Pierre Martinez, Diego Mallo, Thomas G Paulson, Xiaohong Li, Carissa A Sanchez, Brian J Reid, Trevor A Graham, Mary K Kuhner, Carlo C Maley
The low risk of progression of Barrett's esophagus (BE) to esophageal adenocarcinoma can lead to over-diagnosis and over-treatment of BE patients. This may be addressed through a better understanding of the dynamics surrounding BE malignant progression. Although genetic diversity has been characterized as a marker of malignant development, it is still unclear how BE arises and develops. Here we uncover the evolutionary dynamics of BE at crypt and biopsy levels in eight individuals, including four patients that experienced malignant progression...
February 23, 2018: Nature Communications
Don Chamil Codipilly, Apoorva Krishna Chandar, Siddharth Singh, Sachin Wani, Nicholas J Shaheen, John M Inadomi, Amitabh Chak, Prasad G Iyer
BACKGROUND & AIMS: Guidelines recommend endoscopic surveillance of patients with Barrett's esophagus (BE) to identify those with dysplasia (a precursor of carcinoma) or early-stage esophageal adenocarcinoma (EAC), who can be treated endoscopically. However, it is unclear whether surveillance increases survival times of patients with BE. We performed a systematic review and meta-analysis to qualitatively and quantitatively examine evidence for the association of endoscopic surveillance in patients with BE with survival and other outcomes...
February 16, 2018: Gastroenterology
Srinadh Komanduri, V Raman Muthusamy, Sachin Wani
Advances in Endoscopic Eradication Therapy for Barrett's Esophagus associated neoplasia have resulted in a significant paradigm shift in diagnosis and management of this complex disease. A robust body of literature critically evaluating outcomes of resection and ablative strategies has allowed gastroenterologists to make quality, evidence based decisions for their patients. Despite this progress, there are still many unanswered questions and challenges that remain. Ultimately, identification of a cost-effective screening modality, biomarkers for risk stratification, and strides to eliminate post surveillance endoscopy after EET are essential to reach our long term goal for eradication of esophageal adenocarcinoma...
February 16, 2018: Gastroenterology
Jing Lv, Jijun Liu, Lei Guo, Jun Zhang, Yan Cheng, Chu Chen, Heping Zhao, Jihan Wang
Barrett's esophagus (BE) is defined as a metaplasia condition in the distal esophagus, in which the native squamous epithelium lining is replaced by a columnar epithelium with or without intestinal metaplasia. It is commonly accepted that BE is a precancerous lesion for esophageal adenocarcinoma. The aim of this study was to investigate the aberrant microRNAs (miRNAs) and differentially expressed genes (DEGs) associated with BE based on online microarray datasets. One miRNA and five gene expression profiling datasets were retrieved from the Gene Expression Omnibus Database...
February 8, 2018: Cell Cycle
Yating Sun, Shiyang Ma, Li Fang, Jinhai Wang, Lei Dong
BACKGROUND: The diagnosis of Barrett's esophagus (BE) is disturbed by numerous factors, including correct gastroesophageal junction judgment, the initial location of the Z-line and the biopsy result above it. The acetic acid (AA) could help to diagnose BE better than high resolution imaging technology or magnifying endoscopy, by providing enhanced contrast of different epithelium. We have noticed AA could produce multiple white circular lines, forming circular stripes (CS), at lower esophagus, which hasn't been reported by others...
January 25, 2018: BMC 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
Yi-Quan Xiong, Shu-Juan Ma, Hao-Yue Hu, Jing Ge, Li-Zhi Zhou, Shu-Ting Huo, Min Qiu, Qing Chen
AIMS: Barrett's esophagus (BE) predisposes to the development of esophageal neoplasia, including high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). A systematic literature review and meta-analysis were performed to assess the accuracy of within-patient comparisons of narrow band imaging (NBI) and confocal laser endomicroscopy (CLE) for diagnosis of HGD/EAC in patients with BE. METHODS: The following databases were examined up to April 2016 without language restriction: PubMed, Embase, Medline, Web of Science and the Cochrane Library...
December 22, 2017: Clinics and Research in Hepatology and Gastroenterology
M Riegler, I Kristo, M Nikolic, E Rieder, S F Schoppmann
Background: Barrett's esophagus (BE) is the premalignant manifestation of gastroesophageal reflux disease (GERD). Radiofrequency ablation (RFA) with and without endoscopic resection (ER) is a novel treatment for BE. Methods: Here we present a single-center update of the recommendations of a recent (June 2015) interdisciplinary expert panel meeting on the management of BE with dysplasia as well as cancer-positive and cancer-negative BE. We conducted a PubMed search of studies published in 2016 and 2017 on the topic of BE and RFA...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
J Ortiz-Fernandez-Sordo, S Sami, R Mansilla-Vivar, V Subramanian, J Mannath, E Telakis, K Ragunath
Infrared endoscopy (IRE) has been shown to be useful in detecting submucosal (SM) invasion in early gastric cancer. Its role in the endoscopic assessment of Barrett's neoplasia has not been reported to date. We aimed in this study to evaluate the role of IRE in the detection and characterization of early neoplastic lesions within Barrett's esophagus (BE). The secondary aim was to explore its usefulness for the assessment of the presence of submucosal invasion in these early neoplastic Barrett's lesions. We included in the study patients with dysplastic BE who were referred to our institution for endoscopic therapy of a previously diagnosed early Barrett's neoplasia...
December 8, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Masami Omae, Magnus Konradsson, Francisco Baldaque-Silva
A 71-year-old male patient with a long-segment (C10M12) Barrett's esophagus harboring multifocal high-grade dysplasia was referred to our clinic. After a multidisciplinary team conference and the patient's informed consent, an endoscopic submucosal dissection (ESD) was performed with resection of 4/5 of the esophageal circumference along 12 cm, without any complications during or immediately after the procedure. In the day after the ESD, the patient presented suddenly with dyspnea and subcutaneous emphysema in the neck and chest...
December 8, 2017: Clinical Journal of Gastroenterology
Hsin-Yu Fang, Natasha Stephens Münch, Margret Schottelius, Jonas Ingermann, Haibo Liu, Michael Schauer, Stefan Stangl, Gabriele Multhoff, Katja Steiger, Carlos Gerngroß, Moritz Jesinghaus, Wilko Weichert, Anja A Kühl, Antonia R Sepulveda, Hans-Jürgen Wester, Timothy C Wang, Michael Quante
Purpose: Barrett's esophagus represents an early stage in carcinogenesis leading to esophageal adenocarcinoma. Considerable evidence supports a major role for chronic inflammation and diverse chemokine pathways in the development of Barrett's esophagus and esophageal adenocarcinoma. Experimental Design: Here we utilized an IL1β transgenic mouse model of Barrett's esophagus and esophageal adenocarcinoma and human patient imaging to analyze the importance of CXCR4-expressing cells during esophageal carcinogenesis...
December 5, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Hakan Akın, Yücel Aydın
Besides reducing the reflux symptoms, the benefit of proton pump inhibitors (PPI) in the treatment of Barrett's esophagus (BE) is not exactly known. The data in the literature show that although the PPI treatment does not reduce the Barrett's segment length, it can reduce dysplasia or the development of early-stage adenocarcinoma (odds ratio (OR): 0.46). Therefore, treatments with PPI may be considered in patients with a diagnosis of BE and at a high risk of adenocarcinoma, even though they are not symptomatic...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Hakan Akın, Yücel Aydın
Barrett's esophagus (BE) is one of the major complications of gastroesophageal reflux disease (GERD) commonly encountered in gastroenterology clinics. A consensus has not been achieved yet with respect to the definition of BE in published guidelines. It is advised to use the Prague classification and not to use the definition of short and long segments for the endoscopic standardization of BE. Undertaking biopsies with white-light endoscopy from each of the 4 quadrants at 2-cm intervals is the standard method for the diagnosis of BE...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Marc S Levine, Laura R Carucci
Fluoroscopic esophagography is a widely available, safe, and inexpensive test for detecting gastroesophageal reflux disease. In this article, we review the technique for performing a high-quality esophagram, including upright, double-contrast views of the esophagus and cardia with high-density barium; prone, single-contrast views of the esophagus with low-density barium; and evaluation of gastroesophageal reflux. We then discuss the radiographic findings associated with gastroesophageal reflux disease, including esophageal dysmotility, reflux esophagitis, peptic strictures, and Barrett's esophagus...
November 28, 2017: Abdominal Radiology
Arvind J Trindade, Sumant Inamdar, Michael S Smith, Lisa Rosen, Dennis Han, 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 study aims  Little is known about the learning curve for image interpretation in volumetric laser endomicroscopy (VLE) in Barrett's esophagus (BE). The goal of this study was to calculate the learning curve, competence of image interpretation, sensitivity, specificity, and accuracy of VLE among novice users. Methods  31 novice users viewed 96 VLE images electronically at three academic institutions after a brief training session. There were 24 images of each histologic type: normal gastric cardia, normal esophageal squamous epithelium, non-neoplastic BE, and neoplastic BE...
November 27, 2017: Endoscopy
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