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Dysplasia in Barrett's esophagus

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https://www.readbyqxmd.com/read/28617072/evaluation-of-ninepoint-medical-s-nvision-vle-device-for-gastrointestinal-applications
#1
Jeffrey D Mosko, Douglas Pleskow
The incidence of esophageal adenocarcinoma (EAC) has increased over the last few decades. With a known precursor lesion, Barrett's esophagus, this remains a target for screening and surveillance with the goal of detecting and providing curative treatment for early neoplasia. Areas covered: Current surveillance techniques rely on white light endoscopy and random tissue sampling which is time consuming, costly and prone to sampling error. Volumetric laser endomicroscopy (VLE), a second-generation optical coherence technology, has emerged as an advanced imaging modality with the potential to improve dysplasia detection, surveillance and subsequently prevent esophageal adenocarcinoma...
June 15, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28610854/endoscopic-ablation-of-low-grade-dysplasia-in-barrett-s%C3%A2-esophagus-have-all-the-boxes-been-checked-for%C3%A2-us%C3%A2-to-move-on
#2
EDITORIAL
Aanand D Naik, Hashem B El-Serag
No abstract text is available yet for this article.
July 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28579538/late-recurrence-of-barrett-s-esophagus-after-complete-eradication-of-intestinal-metaplasia-is-rare-final-report-from-ablation-in-intestinal-metaplasia-containing-dysplasia-trial
#3
Cary C Cotton, W Asher Wolf, Bergein F Overholt, Nan Li, Charles J Lightdale, Herbert C Wolfsen, Sarina Pasricha, Kenneth K Wang, Nicholas J Shaheen
BACKGROUND & AIMS: The goal of treatment for Barrett's esophagus (BE) with dysplasia is complete eradication of intestinal metaplasia (CEIM). The long-term durability of CEIM has not been well characterized, so the frequency and duration of surveillance are unclear. We report results from a 5-year follow-up analysis of patients with BE and dysplasia treated by radiofrequency ablation (RFA) in the randomized controlled Ablation of Intestinal Metaplasia Containing Dysplasia (AIM) trial...
June 1, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28577773/esophagectomy-for-superficial-esophageal-neoplasia
#4
REVIEW
Thomas J Watson
Endoscopic therapies have become the standard of care for most cases of Barrett's esophagus with high-grade dysplasia or intramucosal adenocarcinoma. Despite a rapid and dramatic evolution in treatment paradigms, esophagectomy continues to occupy a place in the therapeutic armamentarium for superficial esophageal neoplasia. The managing physician must remain cognizant of the limitations of endoscopic approaches and consider surgical resection when they are exceeded. Esophagectomy, performed at experienced centers for appropriately selected patients with early-stage disease can be undertaken with the expectation of cure as well as low mortality, acceptable morbidity, and good long-term quality of life...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577766/beyond-dysplasia-grade-the-role-of-biomarkers-in-stratifying-risk
#5
REVIEW
Kerry B Dunbar, Rhonda F Souza
Gastroenterology society guidelines recommend endoscopic surveillance as a means to detect early stage cancer in Barrett's esophagus. However, the incidence of esophageal adenocarcinoma in Western countries continues to increase, suggesting that this strategy may be inadequate. Current surveillance methods rely on the endoscopist's ability to identify suspicious areas of Barrett's esophagus to biopsy, random biopsies, and on the histopathologic diagnosis of dysplasia. This review highlights the challenges of using dysplasia to stratify cancer risk and addresses the development and use of molecular biomarkers and in vivo molecular imaging to detect early neoplasia in Barrett's esophagus...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577765/the-role-of-adjunct-imaging-in-endoscopic-detection-of-dysplasia-in-barrett-s-esophagus
#6
REVIEW
Pujan Kandel, Michael B Wallace
Advances in imaging technologies have demonstrated promise in early detection of dysplasia and cancer in Barrett's esophagus (BE). Optical chromoendoscopy, dye-based chromoendoscopy, and novel technologies have provided the opportunity to visualize the cellular and subcellular structures. Only narrow-band imaging and acetic acid chromoendoscopy have reached benchmarks for clinical use. Volumetric laser endomicroscopy and molecular imaging are not established for routine use. Best practice in management of BE should be focused on careful endoscopic examination, resection, or ablation of the entire abnormal lesion, as well as the use of available imaging technique that has good diagnostic accuracy...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577764/effectiveness-and-cost-effectiveness-of-endoscopic-screening-and%C3%A2-surveillance
#7
REVIEW
Nina Saxena, John M Inadomi
Guidelines for the screening and surveillance of Barrett's esophagus continue to evolve as the incidence of esophageal adenocarcinoma increases, identification of individuals at highest risk for cancer improves, and management of dysplasia evolves. This article reviews related studies and economic analyses. Advances in diagnosis offer promising strategies to help focus screening efforts on those individuals who are most likely to develop esophageal adenocarcinoma.
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577762/who-deserves-endoscopic-screening-for-esophageal-neoplasia
#8
REVIEW
Christopher H Blevins, Prasad G Iyer
Despite the availability of safe and effective endoscopic treatment of Barrett's esophagus (BE)-related dysplasia and neoplasia, the incidence and mortality from esophageal adenocarcinoma (EAC) have continued to increase. This likely stems from the large population of patients that develop EAC outside of a BE screening and surveillance program. Identification of BE with screening followed by enrollment in an appropriate surveillance/risk stratification program could be a strategy to address both the incidence of and mortality from EAC...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28573176/recurrence-of-intestinal-metaplasia-and-early-neoplasia-after-endoscopic-eradication-therapy-for-barrett-s-esophagus-a-systematic-review-and-meta-analysis
#9
Larissa L Fujii-Lau, Birtukan Cinnor, Nicholas Shaheen, Srinivas Gaddam, Srinadh Komanduri, V Raman Muthusamy, Ananya Das, Robert Wilson, Violette C Simon, Vladimir Kushnir, Daniel Mullady, Steven A Edmundowicz, Dayna S Early, Sachin Wani
BACKGROUND:  Conflicting data exist with regard to recurrence rates of intestinal metaplasia (IM) and dysplasia after achieving complete eradication of intestinal metaplasia (CE-IM) in Barrett's esophagus (BE) patients. AIM:  (i) To determine the incidence of recurrent IM and dysplasia achieving CE-IM and (ii) to compare recurrence rates between treatment modalities [radiofrequency ablation (RFA) with or without endoscopic mucosal resection (EMR) vs stepwise complete EMR (SRER)]...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28566888/risk-of-progression-of-barrett-s-esophagus-in-patients-with-cirrhosis
#10
Tehilla Apfel, Rocio Lopez, Madhusudhan R Sanaka, Prashanthi N Thota
AIM: To study Barrett's esophagus (BE) in cirrhosis and assess progression to esophageal adenocarcinoma (EAC) compared to non-cirrhotic BE controls. METHODS: Cirrhotic patients who were found to have endoscopic evidence of BE confirmed by the presence of intestinal metaplasia on histology from 1/1/2000 to 12/1/2015 at Cleveland Clinic were included. Cirrhotic patients were matched 1:4 to BE controls without cirrhosis. Age, gender, race, BE length, hiatal hernia size, Child-Pugh (CP) class and histological findings were recorded...
May 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28551084/barrett-s-esophagus-ten-years-of-experience-at-a-tertiary-care-hospital-center-in-mexico
#11
F Valdovinos-Andraca, A R Bernal-Méndez, R Barreto-Zúñiga, D Briseño-García, J A Martínez-Lozano, A F Romano-Munive, J Elizondo-Rivera, F I Téllez-Ávila
INTRODUCTION: The prevalence of Barrett's esophagus has been calculated at between 1.3 and 1.6%. There is little information with respect to this in Mexico. AIM: To determine the frequency and characteristics of Barrett's esophagus in patients that underwent endoscopy at a national referral center, within a 10-year time frame. MATERIAL AND METHODS: The databases of the pathology and gastrointestinal endoscopy departments of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" were analyzed, covering the period of January 2002 to December 2012...
May 24, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28550435/lymph-node-retrieval-is-inferior-in-the-modified-merendino-resection-for-early-barrett-s-carcinoma-a-matched-pair-comparison-with-ivor-lewis-resection
#12
Thomas Haist, Markus Mann, Christina Oetzmann von Sochaczewski, Michael Pauthner, Annette Fisseler-Eckhoff, Dietmar Lorenz
AIM OF THE STUDY: A matched-pair comparison between the modified Merendino resection (MER) and Ivor Lewis resection (ILR) for early Barrett's carcinoma. BACKGROUND: Early adenocarcinoma of the esophagus (eACE) with positive risk factors for lymph node metastasis (LNM) needs surgery for cure. MER appeared to be an alternative to ILR. METHODS: Between July 2000 and July 2012, 156 patients with high-grade dysplasia or eACE received ILR, whereas in 30 cases MER was performed in a tertiary care center for GI Surgery...
May 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28548120/early-barrett-esophagus-related-neoplasia-in-segments-1%C3%A2-cm-or-longer-is-always-associated-with-intestinal-metaplasia
#13
Benjamin Michael Allanson, Jessica Bonavita, Bob Mirzai, Tze Sheng Khor, Spiro C Raftopoulos, Willem Bastiaan de Boer, Ian S Brown, Marian Priyanthi Kumarasinghe
The assumption that intestinal metaplasia is a prerequisite for intraepithelial neoplasia/dysplasia and adenocarcinoma in the distal esophagus has been challenged by observations of adenocarcinoma without associated intestinal metaplasia. This study describes our experience of intestinal metaplasia in association with early Barrett neoplasia in distal esophagus and gastroesophageal junction. We reviewed the first endoscopic mucosal resection of 139 patients with biopsy-proven neoplasia. In index endoscopic mucosal resection, 110/139 (79%) cases showed intestinal metaplasia...
May 26, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28546793/current-management-of-low-grade-dysplasia-in-barrett-esophagus
#14
Gary W Falk
Low-grade dysplasia in Barrett esophagus remains an ongoing challenge in clinical management. Recent studies suggest an increased risk in progression of low-grade dysplasia to high-grade dysplasia and/or adenocarcinoma. This is especially seen when 1 or more expert gastrointestinal pathologist confirms the diagnosis and in the setting of low-grade dysplasia that persists on more than 1 endoscopy. In the setting of confirmed and persistent low-grade dysplasia, level 1 evidence supports endoscopic ablation as a treatment option for these patients, although continued surveillance remains a viable option...
April 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28541099/cost-effectiveness-analysis-of-endoscopic-eradication-therapy-for-treatment-of-high-grade-dysplasia-in-barrett-s-esophagus
#15
Alex Filby, Matthew Taylor, Gideon Lipman, Laurence Lovat, Rehan Haidry
AIM: The aim was to evaluate the cost-effectiveness of endoscopic eradication therapy (EET) with combined endoscopic mucosal resection and radiofrequency ablation for the treatment of high-grade dysplasia (HGD) arising in patients with Barrett's esophagus compared with endoscopic surveillance alone in the UK. MATERIALS & METHODS: The cost-effectiveness model consisted of a decision tree and modified Markov model. A lifetime time horizon was adopted with the perspective of the UK healthcare system...
May 25, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28475729/ceacam-6-a-novel-marker-for-the-diagnosis-of-barrett-s-esophagus
#16
N Sharma, S Srivastava, F Kern, W Xian, K G Yeoh, T Ming, F McKeon, K Y Ho
Barrett's esophagus (BE) is a premalignant condition associated with the development of esophageal adenocarcinoma (EAC). Despite the low risk of progression to EAC, evidence highlights the notably poor survival rates of this malignancy. The mainstay form of diagnosis of BE is endoscopy and biopsy sampling. However, research emphasizes limitations with regards to the histological detection of BE and associated dysplasia. The aim of this study is to evaluate the clinical significance of CEACAM6 as a potential biomarker for the diagnosis of BE and beyond...
July 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28469359/probe-confocal-laser-endomicroscopy-in-the-therapeutic-endoscopic-management-of-barrett-s-dysplasia
#17
Fabrice Caillol, Sebastien Godat, Flora Poizat, Aurélie Auttret, Christian Pesenti, Erwan Bories, Jean Phillipe Ratone, Marc Giovannini
BACKGROUND: Endoscopic management of Barrett's esophagus (BE) depends on the histological stage of BE and includes the following: follow up, endotherapy with thermal ablation, and piecemeal or monobloc endoscopic resection (ER). We know that biopsies are unreliable in 20-75% of cases. The aim of our study was to evaluate the efficiency of probe confocal laser endomicroscopy (pCLE) in the diagnosis of the histological stage of BE, compared with the final histological results after ER. METHODS: This retrospective study was based on a prospective registry of patients referred for management of BE-associated dysplasia...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28455160/long-term-follow-up-results-of-stepwise-radical-endoscopic-resection-for-barrett-s-esophagus-with-early-neoplasia
#18
Kamar Belghazi, Frederike G I van Vilsteren, Bas L A M Weusten, Sybren L Meijer, Jacques J G H M Bergman, Roos E Pouw
BACKGROUND & AIMS: Stepwise radical endoscopic resection (SRER) has shown to be effective in eradicating Barrett's esophagus (BE) and its associated dysplasia. The aim of this study was to assess the long-term durability after successful SRER for early Barrett's neoplasia. METHODS: Patients who were treated with SRER for BE ≤5 cm with high-grade dysplasia (HGD) or early cancer (EC) and had reached complete eradication of intestinal metaplasia (CE-IM) and neoplasia (CE-neo) were included...
April 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28446998/pathology-of-esophageal-cancer-and-barrett-s-esophagus
#19
REVIEW
Shilpa Jain, Sadhna Dhingra
Esophageal cancer is a serious malignancy with high mortality. The two common distinctive pathologic subtypes of esophageal cancer are squamous cell carcinoma and adenocarcinoma. These differ with regards to etiology, ethnic distribution, pathogenesis, and location in the esophagus. The precursor lesions are also unique to each subtype. Squamous cell carcinoma is more common in East Asia, is linked to smoking and tobacco use, more commonly involves the middle esophagus, and the precursor lesion is squamous dysplasia...
March 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28446996/barrett-s-esophagus-best-practices-for-treatment-and-post-treatment-surveillance
#20
REVIEW
Nabil M Mansour, Hashem B El-Serag, Sharmila Anandasabapathy
Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes...
March 2017: Annals of Cardiothoracic Surgery
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