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Dysplasia in Barrett's esophagus

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https://www.readbyqxmd.com/read/28078459/endotherapy-in-case-of-relapse-of-neoplastic-barrett-s-esophagus-after-successful-initial-endoscopic-resection
#1
Sébastien Godat, Fabrice Caillol, Aurélie Autret, Erwan Bories, Christian Pesenti, Jean Philippe Ratone, Chiara De Cassan, Flora Poizat, Marc Giovannini
BACKGROUND: Endotherapy in cases of neoplastic Barrett esophagus (BE) relapse after successful initial endoscopic management is commonly accepted, but few studies analyze this topic and also take into account the metachronous lesions. AIMS: To evaluate the efficiency of endotherapy in the case of neoplastic BE relapse after successful complete endoscopic eradication of neoplastic BE and metaplastic BE. METHODS: Retrospective review of medical records was collected in a computerized and prospective manner between 2000 and 2015, in a single tertiary care center...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28072858/proton-pump-inhibitors-do-not-reduce-the-risk-of-esophageal-adenocarcinoma-in-patients-with-barrett-s-esophagus-a-systematic-review-and-meta-analysis
#2
Qiang Hu, Tian-Tian Sun, Jie Hong, Jing-Yuan Fang, Hua Xiong, Stephen J Meltzer
OBJECTIVES: Proton pump inhibitors (PPIs) have been used for treatment of Barrett's esophagus (BE) for many years. However, the connection between PPIs and esophageal adenocarcinoma (EAC) in patients with BE has still been controversial. The current systematic review and meta-analysis was designed to evaluate the association between PPIs and the risk of EAC or high-grade dysplasia (HGD) in patients with BE. METHODS: A systematic literature search of studies reporting the association between PPIs and the risk of EAC and/or HGD in patients with BE was conducted in PubMed, Embase, Web of Science and the Cochrane Library...
2017: PloS One
https://www.readbyqxmd.com/read/28042239/oral-steroid-prophylaxis-is-effective-in-preventing-esophageal-strictures-after-large-endoscopic-resection
#3
Jean-Philippe Ratone, Erwan Bories, Fabrice Caillol, Christian Pesenti, Sebastien Godat, Flora Poizat, Chiara De Cassan, Marc Giovannini
BACKGROUND: Strictures are frequent complications of large endoscopic mucosal resections (EMR) and endoscopic submucosal dissections of the esophagus. Local or systemic steroid therapy has shown promise in the prevention of secondary stenosis. The aim of this study was to evaluate the safety and efficacy of systemic steroid therapy following endoscopic resection of at least hemi-circumferential esophageal mucosa. METHODS: This was a single-center retrospective study in a tertiary center...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28026198/the-importance-of-a-second-opinion-in-the-diagnosis-of-barrett-s-esophagus-a-real-life-study
#4
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/28012849/patients-with-barrett-s-esophagus-and-confirmed-persistent-low-grade-dysplasia-at-increased-risk-for-progression-to-neoplasia
#5
Lucas C Duits, M J van der Wel, Cary C Cotton, K Nadine Phoa, Fiebo J W Ten Kate, Cees A Seldenrijk, G Johan A Offerhaus, Mike Visser, Sybren L Meijer, Rosalie C Mallant-Hent, Kausilia K Krishnadath, Roos E Pouw, Jan G P Tijssen, Nicholas J Shaheen, Jacques J G H M Bergman
BACKGROUND & AIMS: For patients with Barrett's esophagus (BE), the diagnosis of low-grade dysplasia (LGD) is subjective and reported outcomes vary. We analyzed data from a multicenter study of endoscopic therapy to identify factors associated progression to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in patients with LGD of the esophagus. METHODS: We performed a retrospective analysis of data from 255 patients with a primary diagnosis of LGD (78% men; mean age, 63 years) who participated in a randomized controlled trial of surveillance vs radiofrequency ablation in Europe...
December 21, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27999692/polypoid-dysplasia-in-barrett-s-esophagus-diagnosis-management-and-very-different-outcomes-in-two-consecutive-cases
#6
Megan Murphy, Christina Tofani, Kunjal Gandhi, Anthony Infantolino
Background. Barrett's esophagus is associated with an increased risk of adenocarcinoma. Dysplasia in Barrett's esophagus is a precursor to adenocarcinoma. Rarely, dysplastic polypoid lesions are superimposed on Barrett's esophagus. Most reported cases of polypoid dysplasia in Barrett's esophagus have been advanced on presentation and treated with esophagectomy. We describe two cases of polypoid changes in Barrett's esophagus and treatment with polypectomy followed by radiofrequency ablation. Cases. A 75 yo male presented with esophageal polyps, which on biopsy showed gastric cardia/foveolar mucosa with focal intestinal metaplasia without dysplasia...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27997963/efficacy-of-the-cryoballoon-focal-ablation-system-for-the-eradication-of-dysplastic-barrett-s-esophagus-islands
#7
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/27995191/non-radical-stepwise-complete-endoscopic-resection-of-barrett-s-epithelium-in-short-segment-barrett-s-esophagus-has-a-low-stricture-rate
#8
Andreas Koutsoumpas, Lai Mun Wang, Adam A Bailey, Richard Gillies, Robert Marshall, Michael Booth, Bruno Sgromo, Nick Maynard, Barbara Braden
Background and aims: Radical endoscopic excision of Barrett's epithelium performing 4 - 6 endoscopic resections during the same endoscopic session results in complete Barrett's eradication but has a high stricture rate (40 - 80 %). Therefore radiofrequency ablation is preferred after endoscopic mucosal resection (EMR) of visible nodules. We investigated the clinical outcome of non-radical, stepwise endoscopic mucosal resection with a maximum of two endoscopic resections per endoscopic session. Methods: We analysed our prospectively maintained database of patients undergoing esophageal EMR for early neoplasia in Barrett's esophagus from 2009 to 2014...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27988383/low-risk-of-high-grade-dysplasia-or-esophageal-adenocarcinoma-among-patients-with-barrett-s-esophagus-less-than-1-cm-irregular-z-line-within-5-years-of-index-endoscopy
#9
Prashanthi N Thota, Prashanth Vennalaganti, Sreekar Vennelaganti, Patrick Young, Srinivas Gaddam, Neil Gupta, David Lieberman, Richard Sampliner, Gary W Falk, Sharad Mathur, Kevin Kennedy, Brooks D Cash, Fouad Moawad, Ajay Bansal, Manon C Spaander, Marco J Bruno, John Vargo, Prateek Sharma
BACKGROUND & AIMS: Many patients with a less than 1 cm segment of columnar metaplasia in 3 the distal esophagus, also called an irregular Z line, are encountered. These patients, often referred to as patients with Barrett's esophagus (BE), are enrolled in surveillance programs. However, little is known about their risk of high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC). We aimed to determine the incidence of HGD and EAC in patients with irregular Z line with intestinal metaplasia...
December 14, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27984402/adherence-to-surveillance-guidelines-in-nondysplastic-barrett-s-esophagus
#10
Kunal S Dalal, Jessica Coffing, Thomas F Imperiale
INTRODUCTION: Surveillance patterns in Barrett's esophagus (BE) are not well characterized. Guidelines published between 2002 and 2008 recommended surveillance esophagogastroduodenoscopy (sEGD) at 3-year intervals for nondysplastic BE (NDBE). We assessed guideline adherence in incident NDBE in a Veterans Affairs (VA)-based study. METHODS: At a single VA center, we identified incident cases of biopsy-confirmed NDBE between January, 2006 and December, 2008. We excluded patients aged 76 years and above and those who developed BE-associated dysplasia or cancer during follow-up...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27984396/current-endoscopic-approaches-for-the-treatment-of-barrett-esophagus
#11
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/27971324/cost-effectiveness-of-endoscopic-treatment-with-radiofrequency-ablation-for-patients-with-barrett-s-esophagus-and-high-or-low-grade-dysplasia-in-spain
#12
J M Esteban, P González Carro, J Gornals, C Collados, M Álvarez, A Pérez-Mitru, S Serip
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27956164/the-cost-effectiveness-of-radiofrequency-ablation-for-barrett-s-esophagus-with-low-grade-dysplasia-results-from-a-randomized-controlled-trial-surf-trial
#13
K N Phoa, W D Rosmolen, B L A M Weusten, R Bisschops, E J Schoon, S Das, K Ragunath, G Fullarton, M DiPietro, N Ravi, J G P Tijssen, M G W Dijkgraaf, J J G H M Bergman
BACKGROUND & AIMS: The Surveillance versus RadioFrequency ablation (SURF)-trial randomized 136 patients with Barrett's esophagus (BE) containing low-grade dysplasia (LGD), to receive radiofrequency ablation (ablation, n=68) or endoscopic surveillance (control, n=68). Ablation reduced the risk of neoplastic progression to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) by 25% over 3 years (1.5% for ablation vs 26.5% for control). We performed a cost-effectiveness analysis from a provider perspective alongside this trial...
December 9, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27941583/current-endoscopic-approaches-for-the-treatment-of-barrett-esophagus
#14
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/27941559/expression-of-cas-cse1l-the-cellular-apoptosis-susceptibility-protein-correlates-with-neoplastic-progression-in-barrett-s-esophagus
#15
Kun Jiang, Kevin Neill, Daniel Cowden, Jason Klapman, Steven Eschrich, José Pimiento, Mokenge P Malafa, Domenico Coppola
BACKGROUND: Identifying the molecular switch responsible for the neoplastic progression of Barrett's esophagus (BE) and initiation of adenocarcinoma (ADC) is clinically essential and it will have a profound impact on patient diagnosis, prognosis, and treatment. The cellular apoptosis susceptibility gene CAS/CSE1L is overexpressed in various cancers, including a rare report on esophageal ADC; however, its expression in BE neoplasia has not been addressed. MATERIALS AND METHODS: We investigated the expression of the CAS/CSE1L protein immunohistochemically in 56 esophageal resection specimens for ADC arising in BE...
December 9, 2016: Applied Immunohistochemistry & Molecular Morphology: AIMM
https://www.readbyqxmd.com/read/27932981/proton-pump-inhibitors-display-antitumor-effects-in-barrett-s-adenocarcinoma-cells
#16
Eduardo Chueca, Nadezda Apostolova, Juan V Esplugues, María A García-González, Ángel Lanas, Elena Piazuelo
Recent evidence has reported that proton pump inhibitors (PPIs) can exert antineoplastic effects through the disruption of pH homeostasis by inhibiting vacuolar ATPase (H(+)-VATPase), a proton pump overexpressed in several tumor cells, but this aspect has not been deeply investigated in EAC yet. In the present study, the expression of H(+)-VATPase was assessed through the metaplasia-dysplasia-adenocarcinoma sequence in Barrett's esophagus (BE) and the antineoplastic effects of PPIs and cellular mechanisms involved were evaluated in vitro...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27893678/value-of-cyclin-a-immunohistochemistry-for-cancer-risk-stratification-in-barrett-esophagus-surveillance-a-multicenter-case-control-study
#17
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/role-of-eus-in-patients-with-suspected-barrett-s-esophagus-with-high-grade-dysplasia-or-early-esophageal-adenocarcinoma-impact-on-endoscopic-therapy
#18
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/27882416/toward-more-efficient-surveillance-of-barrett-s-esophagus-identification-and-exclusion-of-patients-at-low-risk-of-cancer
#19
Mats Lindblad, Tim Bright, Ann Schloithe, George C Mayne, Gang Chen, Jeff Bull, Peter A Bampton, Robert J L Fraser, Piers A Gatenby, Louisa G Gordon, David I Watson
BACKGROUND: Endoscopic surveillance of Barrett's esophagus (BE) is probably not cost-effective. A sub-population with BE at increased risk of high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) who could be targeted for cost-effective surveillance was sought. METHODS: The outcome for BE surveillance from 2003 to 2012 in a structured program was reviewed. Incidence rates and incidence rate ratios for developing HGD or EAC were calculated. Risk stratification identified individuals who could be considered for exclusion from surveillance...
November 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27855466/detection-of-lesions-in-dysplastic-barrett-s-esophagus-by-community-and-expert-endoscopists
#20
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
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