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Dysplasia in Barrett's esophagus

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https://www.readbyqxmd.com/read/27893678/value-of-cyclin-a-immunohistochemistry-for-cancer-risk-stratification-in-barrett-esophagus-surveillance-a-multicenter-case-control-study
#1
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
#2
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/27882416/toward-more-efficient-surveillance-of-barrett-s-esophagus-identification-and-exclusion-of-patients-at-low-risk-of-cancer
#3
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
#4
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/27846743/support-for-involvement-of-the-renin-angiotensin-system-in-dysplastic-barrett-s-esophagus
#5
Svein Olav Bratlie, Anna Casselbrant, Anders Edebo, Lars Fändriks
BACKGROUND AND AIM: Patients with dysplasia in Barrett's esophagus (BE) have a considerable risk of developing esophageal adenocarcinoma (EAC). The mucosal expression of the pro-inflammatory angiotensin II receptor type 1 (AT1R) is elevated in these patients, suggesting a role in carcinogenesis. The purpose of this study was to determine whether interference with the renin-angiotensin system (RAS) would influence downstream markers of carcinogenesis. METHODS: Endoscopic mucosal biopsies from BE patients with low-grade dysplasia (LGD) were sampled before and after a three-week period of RAS-interfering treatment...
November 16, 2016: Scandinavian Journal of Gastroenterology
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
#6
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
#7
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/27812392/periesophageal-pseudoaneurysms-rare-cause-of-refractory-bleeding-treated-with-transarterial-embolization
#8
Divyanshoo R Kohli, Rachit D Shah, Daniel J Komorowski, George B Smallfield
A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett's esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful...
2016: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/27807078/goblet-cell-ratio-in-combination-with-differentiation-and-stem-cell-markers-in-barrett-esophagus-allow-distinction-of-patients-with-and-without-esophageal-adenocarcinoma
#9
Raphael Schellnegger, Anne Quante, Susanne Rospleszcz, Martina Schernhammer, Bettina Höhl, Moritz Tobiasch, Agnieszka Pastula, Anna Brandtner, Julian A Abrams, Konstantin Strauch, Roland M Schmid, Michael Vieth, Timothy C Wang, Michael Quante
The increasing incidence of esophageal adenocarcinoma (EAC) is mirrored by the increasing prevalence of Barrett esophagus, a precursor lesion resulting in a large number of individuals "at risk" for this lethal malignancy. Among patients with Barrett esophagus, only about 0.3% annually will develop EAC. Because large numbers of patients are followed in endoscopic surveillance, there is a need for risk prediction among a growing population of patients with Barrett esophagus. We identified four potential biomarkers from an inflammation (IL1β)-dependent mouse model of Barrett esophagus and tested them in 189 patients with Barrett esophagus with and without high-grade dysplasia (HGD)/early cancer (T1)...
November 2, 2016: Cancer Prevention Research
https://www.readbyqxmd.com/read/27747281/first-reports-of-esophageal-adenocarcinoma-with-white-globe-appearance-in-japanese-and-caucasian-patients
#10
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
#11
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/27725648/clinical-outcomes-following-recurrence-of-intestinal-metaplasia-after-successful-treatment-of-barrett-s-esophagus-with-radiofrequency-ablation
#12
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
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
#13
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/27688205/endoscopic-submucosal-dissection-for-barrett-s-early-neoplasia-a-multicenter-study-in-the-united-states
#14
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
https://www.readbyqxmd.com/read/27670227/efficacy-and-safety-outcomes-of-multimodal-endoscopic-eradication-therapy-in-barrett-s-esophagus-related-neoplasia-a-systematic-review-and-pooled-analysis
#15
Madhav Desai, Shreyas Saligram, Neil Gupta, Prashanth Vennalaganti, Ajay Bansal, Abhishek Choudhary, Sreekar Vennelaganti, Jianghua He, Mohammad Titi, Roberta Maselli, Bashar Qumseya, Mojtaba Olyaee, Irwing Waxman, Alessandro Repici, Cesare Hassan, Prateek Sharma
BACKGROUND & AIMS: Focal endoscopic mucosal resection followed by radiofrequency ablation (f-EMR+RFA) and step-wise or complete EMR(sEMR) are established strategies for eradication of Barrett's esophagus (BE)-related high-grade dysplasia(HGD) and/or intra-mucosal cancer(EAC/IMC). Objective of this study was to derive pooled rates of efficacy and safety of individual method in a large cohort of BE patients and to perform indirect comparison between 2 methods. METHODS: PubMed, Embase, Web of Science, Cochrane and major conference proceedings were searched...
September 23, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27638535/-pathogenetic-aspects-in-precursor-lesions-of-gastrointestinal-tumors
#16
T Rau
The pathogenesis of precursor lesions of gastrointestinal tumors is manifested in many ways. In the esophagus an aberrant genetic expression of intestinal transcription factors, such as CDX2 is initiated by local environment factors. During the subsequent dysplasia to carcinoma sequence, chromosomal gain and loss of genes occurs. A 4-color fluorescence in situ hybridization (FISH) assay can be applied in dysplasia as well as in Barrett's adenocarcinoma to define prognostic marker combinations. In the gastric carcinogenesis sequence the gene expression of CDX1 is regulatively dependent on an interplay between inflammation and promotor methylation...
November 2016: Der Pathologe
https://www.readbyqxmd.com/read/27621766/endoscopic-applications-of-cryospray-ablation-therapy-from-barrett-s-esophagus-and-beyond
#17
REVIEW
Jayaprakash Sreenarasimhaiah
In the last decade, the treatment of dysplastic Barrett's esophagus has evolved into primarily endoscopic therapy. Many techniques have become well-established to destroy or remove the mucosal lining of Barrett's esophagus. One of the newest therapies, cryospray ablation, has become a modality to treat both dysplastic Barrett's esophagus as well as esophageal carcinoma. In endoscopic applications, the cryogen used is either liquid nitrogen or carbon dioxide which causes tissue destruction through rapid freeze-thaw cycles...
August 25, 2016: World Journal of Gastrointestinal Endoscopy
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/27602241/clinical-significance-and-management-of-barrett-s-esophagus-with-epithelial-changes-indefinite-for-dysplasia
#19
REVIEW
Prashanthi N Thota, Gaurav Kistangari, Ashwini K Esnakula, David Hernandez Gonzalo, Xiu-Li Liu
Barrett's esophagus (BE) is defined as the extension of salmon-colored mucosa into the tubular esophagus ≥ 1 cm proximal to the gastroesophageal junction with biopsy confirmation of intestinal metaplasia. Patients with BE are at increased risk of esophageal adenocarcinoma (EAC), and undergo endoscopic surveillance biopsies to detect dysplasia or early EAC. Dysplasia in BE is classified as no dysplasia, indefinite for dysplasia (IND), low grade dysplasia (LGD) or high grade dysplasia (HGD). Biopsies are diagnosed as IND when the epithelial abnormalities are not sufficient to diagnose dysplasia or the nature of the epithelial abnormalities is uncertain due to inflammation or technical issues...
August 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27583562/cyr61-and-taz-upregulation-and-focal-epithelial-to-mesenchymal-transition-may-be-early-predictors-of-barrett-s-esophagus-malignant-progression
#20
Joana Cardoso, Marta Mesquita, António Dias Pereira, Mónica Bettencourt-Dias, Paula Chaves, José B Pereira-Leal
Barrett's esophagus is the major risk factor for esophageal adenocarcinoma. It has a low but non-neglectable risk, high surveillance costs and no reliable risk stratification markers. We sought to identify early biomarkers, predictive of Barrett's malignant progression, using a meta-analysis approach on gene expression data. This in silico strategy was followed by experimental validation in a cohort of patients with extended follow up from the Instituto Português de Oncologia de Lisboa de Francisco Gentil EPE (Portugal)...
2016: PloS One
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