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Dysplasia in Barrett's esophagus

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https://www.readbyqxmd.com/read/29783927/length-of-barrett-s-segment-predicts-failure-of-eradication-in-radiofrequency-ablation-for-barrett-s-esophagus-a-retrospective-cohort-study
#1
Tyler Luckett, Chaitanya Allamneni, Kevin Cowley, John Eick, Allison Gullick, Shajan Peter
BACKGROUND: We aim to investigate factors that may contribute to failure of eradication of dysplastic Barrett's Esophagus among patients undergoing radiofrequency ablation treatment. METHODS: A retrospective review of patients undergoing radiofrequency ablation for treatment of Barrett's Esophagus was performed. Data analyzed included patient demographics, medical history, length of Barrett's Esophagus, number of radiofrequency ablation sessions, and histopathology...
May 21, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29778551/differences-of-risk-factors-and-clinical-presentations-in-male-and-female-taiwanese-individuals-with-barrett-s-esophagus
#2
Shou-Wu Lee, Han-Chung Lien, Chi-Sen Chang, Chung-Hsin Chang, Chung-Wang Ko, Hong-Zen Yeh
BACKGROUND: Barrett's esophagus (BE) is a disorder more often found in obese men. Differences between the two genders are not known in the Asian countries. Here, we studied their gender differences in the Taiwanese population in terms of risk factors and clinical presentations. METHODS: Data from Taichung Veteran General Hospital were prospectively collected during an approximately two year-period (October 2012 to December 2014). Patients all underwent endoscopic surveillance, and BE was diagnosed based on the typical pattern of intestinal metaplasia...
May 16, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29766388/molecular-evolution-of-metaplasia-to-adenocarcinoma-in-the-esophagus
#3
REVIEW
William M Grady, Ming Yu
Esophageal adenocarcinoma (EAC) develops from Barrett's esophagus (BE), a condition where the normal squamous epithelia is replaced by specialized intestinal metaplasia in response to chronic gastroesophageal acid reflux. In a minority of individuals, BE can progress to low- and high-grade dysplasia and eventually to intra-mucosal and then invasive carcinoma. BE provides researchers with a unique model to characterize the process by which a carcinoma arises from its precursor lesion. Molecular studies of BE have demonstrated that it is not simply a metaplastic tissue, but rather it harbors frequent alterations that are also present in dysplastic BE and in EAC...
May 15, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29764708/histological-assessment-use-of-immunohistochemical-markers-for-detection-of-dysplasia-in-barrett-s-esophageal-mucosa
#4
Prateek Kinra, Gaurav P S Gahlot, Rajni Yadav, Vandana Baloda, Govind K Makharia, Siddhartha Datta Gupta, Prasenjit Das
BACKGROUND: Histological assessment of dysplasia in Barrett's esophagus (BE) has high inter-observer variability. Hence, use of ancillary markers for early detection of dysplasia in BE is an important clinical question. METHODS: In this retrospective study consecutive cases of BE (n = 59), over a period of 4 years were included. Hematoxylin and eosin stained sections were reviewed independently by 3 senior qualified pathologists, who graded the dysplasia according to the Vienna Classification system and inter-observer agreement was analysed using the Kappa statistics...
May 13, 2018: Pathology, Research and Practice
https://www.readbyqxmd.com/read/29752721/can-endoscopic-resection-for-barrett-s-dysplasia-and-early-cancer-be-curative
#5
REVIEW
Shai Friedland, George Triadafilopoulos
Effective endoscopic treatments for dysplasia and early (intramucosal) cancer, together with expanded and rigorous screening programs to detect Barrett's esophagus, could help reverse the increase in the incidence of esophageal cancer and reduce esophageal cancer-related mortality. In this review, we discuss the long-term outcomes for mucosal resection for dysplasia and early cancer and compares them to esophagectomy as the standard of care choice. Eendoscopic resection for Barrett's dysplasia and early cancer can be curative but only when the lesion can be classified as: Paris type I (polypoid); Paris IIa (slightly elevated); Paris IIb (flat); Paris IIc (slightly depressed); histological grades G1 and G2; high-grade dysplasia...
May 11, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29749623/gastrointestinal-pathologists-perspective-on-managing-risk-in-the-distal-esophagus-convergence-on-a-pragmatic-approach
#6
Andrew M Bellizzi, Sara Hafezi-Bakhtiari, Maria Westerhoff, E Celia Marginean, Robert H Riddell
Here, we discuss recent updates and a continuing controversy in the diagnosis and management of Barrett's esophagus, specifically the recommendation that the irregular Z-line not be biopsied, the diminished status of ultrashort-segment Barrett's esophagus, the evidence basis for excluding and including the requirement of goblet cells for the diagnosis of Barrett's esophagus, and the conclusion that histologically confirmed low-grade dysplasia is best managed with endoscopic ablation rather than surveillance...
May 11, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29739803/centrosome-amplification-arises-before-neoplasia-and-increases-upon-p53-loss-in-tumorigenesis
#7
Carla A M Lopes, Marta Mesquita, Ana Isabel Cunha, Joana Cardoso, Sara Carapeta, Cátia Laranjeira, António E Pinto, José B Pereira-Leal, António Dias-Pereira, Mónica Bettencourt-Dias, Paula Chaves
Centrosome abnormalities are a typical hallmark of human cancers. However, the origin and dynamics of such abnormalities in human cancer are not known. In this study, we examined centrosomes in Barrett's esophagus tumorigenesis, a well-characterized multistep pathway of progression, from the premalignant condition to the metastatic disease. This human cancer model allows the study of sequential steps of progression within the same patient and has representative cell lines from all stages of disease. Remarkably, centrosome amplification was detected as early as the premalignant condition and was significantly expanded in dysplasia...
May 8, 2018: Journal of Cell Biology
https://www.readbyqxmd.com/read/29717405/risk-of-gerd-related-disorders-in-obese-patients-on-ppi-therapy-a-population-analysis
#8
Simon Erridge, Osama M Moussa, Paul Ziprin, Ara Darzi, Sanjay Purkayastha
BACKGROUND: Increasing prevalence of obesity has shown an associated increase in gastroesophageal reflux disease (GERD)-related diseases. Proton pump inhibitor (PPI) therapy has been demonstrated to reduce the incidence of such diseases. The study's aim was to analyze the Clinical Practice Research Datalink (CPRD) to determine factors that increase the propensity of obese patients on PPIs to develop Barrett's esophagus (BE) and esophageal carcinoma. METHOD: A case-control population study was carried out, including patients from the CPRD...
May 1, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29713986/point-counterpoint-screening-and-surveillance-for-barrett-s-esophagus-is-it-worthwhile
#9
REVIEW
Fouad Otaki, Prasad G Iyer
The exponential rise in incidence of esophageal adenocarcinoma (EAC), paired with persistently poor survival, continues to drive efforts to improve and optimize screening and surveillance practices. While advancements in endoscopic therapy have generated a shift in management and significantly improved the outcomes of patients with early-stage EAC, the majority of prevalent EAC continues to be diagnosed at advanced stages, remaining ineligible for curative therapy. Barrett's esophagus (BE) screening, when applied to high-yield target populations, using minimally or noninvasive accurate tests, followed by endoscopic surveillance to detect prevalent or incident dysplasia/EAC (which can then be treated successfully) is the cornerstone of the current BE management paradigm...
April 30, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29713984/biomarkers-of-barrett-s-esophagus-from-the-laboratory-to-clinical-practice
#10
REVIEW
Vani J A Konda, Rhonda F Souza
The currently recommended approach to managing cancer risk for patients with Barrett's esophagus is endoscopic surveillance including a biopsy protocol to sample the esophageal tissue randomly to detect dysplasia. However, there are numerous limitations in this practice that rely on the histopathological grading of dysplasia alone to make clinical decisions. The availability of in silico models demonstrating the potential cost-effectiveness of biomarker-based stratification has increased interest in finding a clinically relevant "Barrett's biomarker...
April 30, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29697438/improved-progression-prediction-in-barrett-s-esophagus-with-low-grade-dysplasia-using-specific-histologic-criteria
#11
Fiebo J C Ten Kate, Daan Nieboer, Fiebo J W Ten Kate, Michail Doukas, Marco J Bruno, Manon C W Spaander, Leendert H J Looijenga, Katharina Biermann
Risk stratification of patients with Barrett's esophagus (BE) is based on diagnosis of low-grade dysplasia (LGD). LGD has a poor interobserver agreement and a limited value for prediction of progression to high-grade dysplasia or esophageal adenocarcinoma. Specific reproducible histologic criteria may improve the predictive value of LGD. Four gastrointestinal pathologists examined 12 histologic criteria associated with LGD in 84 BE patients with LGD (15 progressors and 69 nonprogressors). The criteria with at least a moderate (kappa, 0...
April 24, 2018: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29689573/systematic-review-and-meta-analysis-of-the-effectiveness-of-radiofrequency-ablation-in-low-grade-dysplastic-barrett-s-esophagus
#12
Gargi Pandey, Mubashir Mulla, Wyn G Lewis, Antonio Foliaki, David S Y Chan
BACKGROUND:  Barrett's esophagus (BE) is a premalignant condition characterized by replacement of the esophageal lining with metastatic columnar epithelium, and its management when complicated by low grade dysplasia (LGD) is controversial. This systematic review and meta-analysis aimed to determine the efficacy of radiofrequency ablation (RFA) in patients with LGD. METHODS:  MEDLINE, EMBASE, and Web of Science were searched for studies including patients with BE-associated LGD receiving RFA (January 1990 to May 2017)...
April 24, 2018: Endoscopy
https://www.readbyqxmd.com/read/29676351/evaluation-of-p53-protein-expression-in-barrett-esophagus
#13
Mahathi Krothapalli, Jyoti Ramnath Kini, Hema Kini, Kausalya Kumari Sahu, Suresh Shenoy, Sandeep Gopal Krishna, B V Tantry
Background: Loss of heterozygosity of p53 along with aneuploidy is deemed to be the early molecular steps in Barrett metaplasia-dysplasia-adenocarcinoma sequence. Objective biomarkers need to be used along with microscopy for risk stratification to predict the progression of Barrett esophagus (BE) to carcinoma. Aim: This study aims to study p53 protein expression in dysplasia and correlate the same with morphology in BE. Materials and Methods: A time-bound study was conducted from January 2011 to June 2015...
April 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29675664/how-should-we-report-endoscopic-results-in-patient-s-with-barrett-s-esophagus
#14
REVIEW
Venkata Subhash Gorrepati, Prateek Sharma
Barrett's esophagus is the only known pre-cancerous lesion for esophageal adenocarcinoma and is diagnosed by high-definition white light endoscopy demonstrating a columnar-lined esophagus along with biopsy evidence of intestinal metaplasia. With accurate performance and reporting of the endoscopic procedure, an evidence-based management strategy can be developed for treatment of Barrett's dysplasia. However, cross-sectional data demonstrate that there is still inconsistency among gastroenterologists in performance and reporting of endoscopic findings in patients with Barrett's esophagus...
April 19, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29671157/natural-history-of-the-post-ablation-esophagus
#15
REVIEW
Craig C Reed, Nicholas J Shaheen
Endoscopic ablative therapy including radiofrequency ablation (RFA) represents the preferred management strategy for dysplastic Barrett's esophagus (BE) and appears to diminish the risk of developing esophageal adenocarcinoma (EAC). Limited data describe the natural history of the post-ablation esophagus. Recent findings demonstrate that recurrent intestinal metaplasia (IM) following RFA is relatively frequent. However, dysplastic BE and EAC subsequent to the complete eradication of intestinal metaplasia (CEIM) are uncommon...
April 18, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29662006/hyperinsulinemia-promotes-esophageal-cancer-development-in-a-surgically-induced-duodeno-esophageal-reflux-murine-model
#16
Diletta Arcidiacono, Arben Dedja, Cinzia Giacometti, Matteo Fassan, Daniele Nucci, Simona Francia, Federico Fabris, Alice Zaramella, Emily J Gallagher, Mauro Cassaro, Massimo Rugge, Derek LeRoith, Alfredo Alberti, Stefano Realdon
Hyperinsulinemia could have a role in the growing incidence of esophageal adenocarcinoma (EAC) and its pre-cancerous lesion, Barrett's Esophagus, a possible consequence of Gastro-Esophageal Reflux Disease. Obesity is known to mediate esophageal carcinogenesis through different mechanisms including insulin-resistance leading to hyperinsulinemia, which may mediate cancer progression via the insulin/insulin-like growth factor axis. We used the hyperinsulinemic non-obese FVB/N (Friend leukemia virus B strain) MKR (muscle (M)-IGF1R-lysine (K)-arginine (R) mouse model to evaluate the exclusive role of hyperinsulinemia in the pathogenesis of EAC related to duodeno-esophageal reflux...
April 14, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29655833/development-of-evidence-based-surveillance-intervals-following-radiofrequency-ablation-of-barrett-s-esophagus
#17
Cary C Cotton, Rehan Haidry, Aaron P Thrift, Laurence Lovat, Nicholas J Shaheen
BACKGROUND AND AIMS: Barrett's esophagus (BE) recurs in 25% or more of patients treated successfully with radiofrequency ablation (RFA), so surveillance endoscopy is recommended after complete eradication of intestinal metaplasia (CEIM). The frequency of surveillance is informed only by expert opinion. We aimed to model the incidence of neoplastic recurrence, validate the model in an independent cohort, and propose evidence-based surveillance intervals. METHODS: We collected data from the United States Radiofrequency Ablation Registry (US RFA, 2004-2013) and the United Kingdom National Halo Registry (UK NHR, 2007-2015) to build and validate models to predict the incidence of neoplasia recurrence following initially successful RFA...
April 12, 2018: Gastroenterology
https://www.readbyqxmd.com/read/29626734/a-survey-on-barrett-s-esophagus-analysis-using-machine-learning
#18
REVIEW
Luis A de Souza, Christoph Palm, Robert Mendel, Christian Hook, Alanna Ebigbo, Andreas Probst, Helmut Messmann, Silke Weber, João P Papa
This work presents a systematic review concerning recent studies and technologies of machine learning for Barrett's esophagus (BE) diagnosis and treatment. The use of artificial intelligence is a brand new and promising way to evaluate such disease. We compile some works published at some well-established databases, such as Science Direct, IEEEXplore, PubMed, Plos One, Multidisciplinary Digital Publishing Institute (MDPI), Association for Computing Machinery (ACM), Springer, and Hindawi Publishing Corporation...
March 30, 2018: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/29626424/multifocal-nitrous-oxide-cryoballoon-ablation-with-or-without-emr-for-treatment-of-neoplastic-barrett-s-esophagus
#19
Marcia Irene Canto, Nicholas J Shaheen, Jose Alejandro Almario, Lysandra Voltaggio, Elizabeth Montgomery, Charles J Lightdale
BACKGROUND AND AIMS: Endoscopic cryotherapy can eradicate neoplastic Barrett's esophagus (BE). A new contact cryoballoon focal ablation system (CbFAS)) freezes esophageal mucosa with nitrous oxide. We studied the safety and efficacy of CbFAS for complete eradication of neoplastic Barrett's esophagus. METHODS: In a prospective clinical trial, consecutive BE patients with confirmed neoplasia (low-grade dysplasia LGD, high-grade dysplasia HGD, and/or intramucosal adenocarcinoma ImCA), at least 1 cm of BE, with or without prior ablation, were treated with a dose 10 seconds of spray per site...
April 4, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29608884/detection-of-mutations-in-barrett-s-esophagus-before-progression-to-high-grade-dysplasia-or-adenocarcinoma
#20
Matthew D Stachler, Nicholas D Camarda, Christopher Deitrick, Anthony Kim, Agoston T Agoston, Robert D Odze, Jason L Hornick, Anwesha Nag, Aaron R Thorner, Matthew Ducar, Amy Noffsinger, Richard H Lash, Mark Redston, Scott L Carter, Jon M Davison, Adam J Bass
BACKGROUND & AIMS: Barrett's esophagus (BE) is the greatest risk factor for esophageal adenocarcinoma, but only a small proportion of patients with BE develop cancer. Biomarkers might be able to identify patients at highest risk of progression. We investigated genomic differences in surveillance biopsies collected from patients whose BE subsequently progressed compared to patients whose disease did not progress. METHODS: We performed a retrospective case-control study of 24 patients with BE that progressed to high-grade dysplasia (HGD, n=14) or esophageal adenocarcinoma (EAC, n=10)...
March 30, 2018: Gastroenterology
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