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Barrett esophagus

Yuji Nadatani, Xiaofang Huo, Xi Zhang, Chunhua Yu, Edaire Cheng, Qiuyang Zhang, Kerry B Dunbar, Arianne Theiss, Thai H Pham, David H Wang, Toshio Watanabe, Yasuhiro Fujiwara, Tetsuo Arakawa, Stuart J Spechler, Rhonda F Souza
BACKGROUND & AIMS: Microbial molecular products incite intestinal inflammation by activating Toll-like receptors (TLRs) and inflammasomes of the innate immune system. This system's contribution to esophageal inflammation is not known. Gram-negative bacteria, which dominate the esophageal microbiome in reflux esophagitis, produce lipopolysaccharide (LPS), a TLR4 ligand. TLR4 signaling produces pro-interleukin (IL)1β, pro-IL18, and NOD-like receptor protein 3 (NLRP3), which prime the NLRP3 inflammasome...
July 2016: Cellular and Molecular Gastroenterology and Hepatology
Wilda D Rosmolen, Pythia T Nieuwkerk, Roos E Pouw, Mark I van Berge Henegouwen, Jacques J G H M Bergman, Mirjam A G Sprangers
Endoscopic therapy is the treatment of choice for high grade intraepithelial neoplasia (HGIN) or early cancer (≤T1sm1) in Barrett's esophagus (BE). We prospectively evaluated the effect of endoscopic treatment on quality of life (QOL) and fear of cancer (recurrence) and compared this with the effect of Barrett's surveillance or surgery. Patients treated endoscopically for early Barrett's neoplasia (n = 42, HGIN - T1sm1N0M0) were compared with three groups: patients with non-dysplastic BE undergoing surveillance (n = 44); patients treated surgically for early BE neoplasia (HGIN - T2N0M0, n = 21); patients treated surgically for advanced BE cancer (T1N1M0 - T3N1M0, n = 19)...
October 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Rita Barros, Daniela Pereira, Catarina Callé, Vânia Camilo, Ana Isabel Cunha, Leonor David, Raquel Almeida, António Dias-Pereira, Paula Chaves
Barrett's esophagus (BE) is the replacement of the normal esophageal squamous epithelium by a columnar lining epithelium. It is a premalignant condition for the development of adenocarcinoma of the esophagus and esophagogastric junction. BE is associated with gastroesophageal reflux which might change the expression profile of key transcription factors involved in the establishment of tissue differentiation, namely, SOX2 (associated with esophageal and gastric differentiation) and CDX2 (associated with intestinal differentiation)...
2016: Disease Markers
Francesco Cavallin, Marco Scarpa, Matteo Cagol, Rita Alfieri, Alberto Ruol, Vanna Chiarion Sileni, Ermanno Ancona, Carlo Castoro
OBJECTIVE: The aim of this study was to investigate trends in patients' characteristics and comorbidities in esophageal cancer (EC) patients. BACKGROUND: Identifying changing pattern is essential to understand and predict further changes and to plan surgical procedures and resource allocation. METHODS: Trends in patients' characteristics and comorbidities were evaluated in 4440 EC patients at the Center for Esophageal Diseases in Padova, Italy, during 1980 to 2011...
October 17, 2016: Annals of Surgery
J Labenz
Barrett's esophagus is an endoscopically visible metaplasia of the columnar epithelium in the esophagus with histological detection of a specialized intestinal metaplasia. The circumferential and longitudinal extent are described endoscopically using the Prague classification. Barrett's esophagus mostly occurs as the result of gastroesophageal reflux disease. The risk of developing esophageal adenocarcinoma is increased but the absolute risk is low with 0.10-0.15 % per year. According to guideline recommendations, screening for Barrett's esophagus as well as endoscopic and biopsy surveillance should be limited to high risk groups...
October 18, 2016: Der Internist
Shou-Wu Lee, Han-Chung Lien, Chi-Sen Chang, Teng-Yu Lee, Yen-Chun Peng, Hong-Zen Yeh
BACKGROUND: Metabolic syndrome has been highlighted as a risk factor for several gastrointestinal diseases, including gastroesophageal reflux disease and Barrett's esophagus (BE). The aim of this study was to investigate the association of metabolic syndrome with erosive esophagitis (EE) and BE. METHODS: Data were retrospectively collected from patients who visited the Medical Screening Center at Taichung Veterans General Hospital, Taichung, Taiwan from January 2006 to December 2009...
October 15, 2016: Journal of the Chinese Medical Association: JCMA
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
Nurdan Tözün, Eser Vardareli
Gastrointestinal (GI) cancers are the leading cause of mortality worldwide. These cancers are the end result of a complex interplay between gene and environment. Bacteria, parasites, and viruses have been implicated in some cancers. Recent data have put at focus the gut microbiome as the key player firing tumorigenesis. Experimental and human studies have provided evidence on the role of microbiota in cancer development. Although subject to changes in different settings such as antibiotic treatment, diet or lifestyle, our microbiome is quite stable and is capable of increasing susceptibility to cancer or decrease and halt its progression...
November 2016: Journal of Clinical Gastroenterology
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
Jia Zeng, Laimonas Kelbauskas, Aida Rezaie, Kristen Lee, Benjamin Ueberroth, Weimin Gao, Dmitry Derkach, Thai Tran, Dean Smith, Kimberly J Bussey, Deirdre R Meldrum
In carcinogenesis, intercellular interactions within and between cell types are critical but remain poorly understood. We present a study on intercellular interactions between normal and premalignant epithelial cells and their functional relevance in the context of premalignant to malignant progression in Barrett's esophagus. Using whole transcriptome profiling we found that in the presence of normal epithelial cells, dysplastic cells but not normal cells, exhibit marked down-regulation of a number of key signaling pathways, including the transforming growth factor beta (TGFβ) and epithelial growth factor (EGF)...
October 12, 2016: Scientific Reports
Moon Kyung Joo, Jong-Jae Park, Hoon Jai Chun
Homeobox genes, including HOX and non-HOX genes, have been identified to be expressed aberrantly in solid tumors. In gastrointestinal (GI) cancers, most studies have focused on the function of non-HOX genes including caudal-related homeobox transcription factor 1 (CDX1) and CDX2. CDX2 is a crucial factor in the development of pre-cancerous lesions such as Barrett's esophagus or intestinal metaplasia in the stomach, and its tumor suppressive role has been investigated in colorectal cancers. Recently, several HOX genes were reported to have specific roles in GI cancers; for example, HOXA13 in esophageal squamous cell cancer and HOXB7 in stomach and colorectal cancers...
October 7, 2016: World Journal of Gastroenterology: WJG
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
Athidi Guthikonda, Cary C Cotton, Ryan D Madanick, Melissa B Spacek, Susan E Moist, Kathleen Ferrell, Evan S Dellon, Nicholas J Shaheen
OBJECTIVES: Radiofrequency ablation (RFA) is an effective treatment for Barrett's esophagus (BE). However, recurrence of BE after initially successful RFA is common, and outcomes following recurrence not well described. We report the outcomes associated with recurrence following initially successful RFA. METHODS: We performed a retrospective cohort study of 306 patients treated with RFA for dysplastic BE. Complete eradication of intestinal metaplasia (CE-IM) was defined as complete histological and endoscopic remission of IM...
October 11, 2016: American Journal of Gastroenterology
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
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
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
Arvind J Trindade, Kostas Sideridis, Rebecca M Thomas
No abstract text is available yet for this article.
October 2016: American Journal of Gastroenterology
Wu Yan, Haoxiang Zhang, Jingwen Li, Caifei Shen, Yiju Xia, Pu Wang, Yafei Zhang, Ji Feng, Shunzi Shao, Xiaona Yu, Dianchun Fang
INTRODUCTION: Barrett's esophagus is a metaplastic lesion. However, the cellular and molecular mechanisms involved are poorly understood. The aim of this study was to investigate the roles of KLF4 and BMP4 in the pathogenesis of Barrett's epithelium. MATERIALS AND METHODS: Immunohistochemistry was used to analyse the expression of KLF4, BMP4, CDX2, MUC2 and MUC5AC in human esophageal specimens. Human esophageal squamous epithelial cells were subjected to bile acid treatment and used in transfection experiments...
September 28, 2016: Experimental and Molecular Pathology
Romy E Verbeek, Peter D Siersema, Frank P Vleggaar, Fiebo J Ten Kate, George Posthuma, Rhonda F Souza, Judith de Haan, Jantine W P M van Baal
BACKGROUND AND AIMS: Inflammation plays an important role in the development of esophageal adenocarcinoma and its metaplastic precursor lesion, Barrett's esophagus. Toll-like receptor (TLR) 2 signalling and lysosomal function have been linked to inflammation-associated carcinogenesis. We examined the expression of TLR2 in the esophagus and the effect of long-term TLR2 activation on morphological changes and expression of factors involved in lysosomal function in a Barrett's esophagus epithelium cell line...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Dennis Yang, Roxana M Coman, Michel Kahaleh, Irving Waxman, Andrew Y Wang, Amrita Sethi, Ashish R Shah, Peter V Draganov
BACKGROUND: and Study Aim: The role of endoscopic submucosal dissection (ESD) in Barrett's early neoplasia is not well-defined, with most studies originating from Asia and Europe. We aimed to assess the efficacy, safety, and results of ESD in Barrett's esophagus (BE) with high-grade dysplasia (HGD) and early adenocarcinoma (EAC) across centers in the United States. METHODS: Multicenter retrospective analysis on 46 patients with BE who underwent ESD for BE-HGD and/or EAC between January 2010 and April 2015...
September 26, 2016: Gastrointestinal Endoscopy
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