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Dysplasia in Barrett's esophagus

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https://www.readbyqxmd.com/read/29135518/substantial-interobserver-agreement-in-the-diagnosis-of-dysplasia-in-barrett-esophagus-upon-review-of-a-patient-s-entire-set-of-biopsies
#1
Marcela A Salomao, Dora Lam-Himlin, Rish K Pai
The pathologic diagnosis of dysplasia in Barrett esophagus (BE) suffers from interobserver disagreement. Many of the studies demonstrating disagreement in the diagnosis of dysplasia have pathologists review individual biopsy slides in isolation. To more closely mimic daily practice, 3 pathologists reviewed hematoxylin and eosin slides made from 549 individual biopsy jars obtained from 129 unique patients with a diagnosis of BE. Each pathologist reviewed the entirety of a given patient's biopsy material. The grade of dysplasia present in each biopsy jar was given as well as an overall highest grade of dysplasia from the patient's entire set of biopsies...
November 9, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29129090/screening-and-prevention-strategies-and-endoscopic-management-of-early-esophageal-cancer
#2
James A Kim, Pari M Shah
Esophageal cancer is the 8th most common cancer worldwide and the 6th most common cause of cancer-related death. Its two main subtypes, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC), have varying incidences globally, but recent decades have seen a demonstrated rise of EAC in Western countries whereas ESCC remains highly prevalent in Eastern Africa, Central Asia, and China. Screening interventions have focused on using endoscopy to identify Barrett's esophagus (BE) as a precursor to EAC, and squamous cell dysplasia prior to onset of ESCC...
October 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/29124122/patient-decision-making-and-clinical-outcomes-following-endoscopic-therapy-or-esophagectomy-for-barrett-s-neoplasia
#3
Robert Lockwood, Elissa Ozanne, Chin Hur, Patrick Yachimski
Background and study aims:  The objective of this study was to assess patient involvement in decision-making, decision confidence, and decision regret among patients who had undergone endoscopic eradication therapy (EET) or esophagectomy for Barrett's esophagus (BE) associated neoplasia. Patients and methods:  Patients with BE high grade dysplasia or intramucosal (T1a) adenocarcinoma who had undergone EET or esophagectomy were invited to complete a survey. Results:  The cohort included 50 subjects, 70 % (35/50) of whom had undergone EET and 30 % (15/50) of whom had undergone esophagectomy...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29103533/diagnosis-and-management-of-barrett-related-neoplasia-in-the-modern-era
#4
REVIEW
Lysandra Voltaggio, Elizabeth A Montgomery
Whereas in the past, pathologists were hesitant to diagnose high-grade dysplasia in patients with Barrett esophagus, because this diagnosis prompted esophagectomy, current international consensus is that endoscopic treatment is the management for high-grade dysplasia and intramucosal carcinoma. Furthermore, many centers advocate endoscopic ablation for low-grade dysplasia. As such, establishing a diagnosis of dysplasia has become the key step; separation between the grades of dysplasia is less critical. This article offers some criteria for separating dysplasia from reactive changes, discusses pitfalls in interpreting endoscopic mucosal resection specimens, and outlines management strategies...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29078688/endoscopic-mucosal-ablation-and-resection-of-barrett-s-esophagus-and-related-diseases
#5
REVIEW
Juan A Muñoz-Largacha, Virginia R Litle
The prevalence of gastroesophageal reflux disease as well as the incidence of Barrett's esophagus (BE) has increased in the Western world over the last decades. The chronic reflux of gastric secretions injuries the esophageal mucosa and triggers cellular and molecular changes inducing the transformation of the normal squamous mucosa into columnar metaplastic epithelium. BE is a premalignant condition that can progress to low-grade dysplasia, high-grade dysplasia and ultimately esophageal adenocarcinoma. An early diagnosis of dysplastic changes and the adoption of appropriate therapeutic approaches are essential to improve patient outcomes and survival...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29066320/detection-of-genetic-alterations-in-cfdna-as-a-possible-strategy-to-monitor-the-neoplastic-progression-of-barrett-s-esophagus
#6
Enrica Rumiato, Elisa Boldrin, Sandro Malacrida, Stefano Realdon, Matteo Fassan, Tiziana Morbin, Giorgio Battaglia, Alberto Amadori, Massimo Rugge, Daniela Saggioro
Barrett's esophagus (BE) is associated with an increased risk of developing esophageal adenocarcinoma. Despite the low absolute risk of neoplastic progression of BE, probability increases with the diagnosis of dysplasia. For this reason, BE patients undergo an endoscopy-based surveillance that is, however, burdensome for patients, subject to inter-observer subjectivity, and expensive for national health systems. Thus, less invasive and low-cost diagnostic tools are needed. This study is aimed at finding a simple and reliable method to detect the circulating cell-free DNA (cfDNA) in BE patients as evidence of the molecular instability that accompanies BE carcinogenesis...
October 6, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/29065436/hot-avulsion-may-be-effective-as-salvage-treatment-for-focal-barrett-s-esophagus-remaining-after-endoscopic-therapy-for-dysplasia-or-early-cancer-a-preliminary-study
#7
Javier Aranda-Hernández, Yuto Shimamura, Andrea Grin, Yugo Iwaya, Maria Cirocco, Gabor Kandel, Gary May, Paul Kortan, Spiro Raftopoulos, Norman Marcon
Background and study aim Both endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) are used to treat Barrett's esophagus (BE) complicated by dysplasia and intramucosal cancer. However, focal areas of BE can remain after otherwise successful application of these techniques. We report the results of hot avulsion using a hot biopsy forceps to resect these residual focal areas. Patients and methods This was a retrospective study from a prospective database in a tertiary reference center from August 2013 to May 2015...
October 24, 2017: Endoscopy
https://www.readbyqxmd.com/read/29036431/longitudinal-outcomes-of-radiofrequency-ablation-versus-surveillance-endoscopy-for-barrett-s-esophagus-with-low-grade-dysplasia
#8
A Kahn, M Al-Qaisi, V T Kommineni, J K Callaway, E S Boroff, G E Burdick, D M Lam-Himlin, M Temkit, M F Vela, F C Ramirez
Radiofrequency ablation of Barrett's esophagus with low-grade dysplasia is recommended in recent American College of Gastroenterology guidelines, with endoscopic surveillance considered a reasonable alternative. Few studies have directly compared outcomes of radiofrequency ablation to surveillance and those that have are limited by short duration of follow-up. This study aims to compare the long-term effectiveness of radiofrequency ablation versus endoscopic surveillance in a large, longitudinal cohort of patients with Barrett's esophagus, and low-grade dysplasia...
September 27, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29036278/perceptions-of-risk-and-therapy-among-patients-with-barrett-s-esophagus-a-patient-survey-study
#9
M W Stier, N Lodhia, J Jacobs, D Nozicka, R Kavitt, U Siddiqui, I Waxman, V J Konda
Nondysplastic Barrett's esophagus has a risk of progression to esophageal adenocarcinoma as low as 0.18-0.3% per person per year, and low-grade dysplasia as low as 0.5%. While adherence to guidelines and selection of management options varies, little is known about what modifies patient decision-making. This study aims to evaluate and identify factors that influence patient perceptions of risk and decisions about management. An independently developed and piloted survey was administered to patients at an academic hospital...
September 21, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28979713/efficacy-and-safety-of-liquid-nitrogen-cryotherapy-for-treatment-of-barrett-s-esophagus
#10
Kristen Suchniak-Mussari, Charles E Dye, Matthew T Moyer, Abraham Mathew, Thomas J McGarrity, Eileen M Gagliardi, Jennifer L Maranki, John M Levenick
AIM: To evaluate the efficacy and safety of liquid nitrogen cryotherapy as a primary or rescue treatment for BE, with and without dysplasia, or intramucosal adenocarcinoma (IMC). METHODS: This was a retrospective, single-center study carried out in a tertiary care center including 45 patients with BE who was treatment-naïve or who had persistent intestinal metaplasia (IM), dysplasia, or IMC despite prior therapy. Barrett's mucosa was resected via EMR when clinically appropriate, then patients underwent cryotherapy until eradication or until deemed to have failed treatment...
September 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28978001/tenascin-c-and-fibronectin-in-normal-esophageal-mucosa-barrett-s-esophagus-dysplasia-and-adenocarcinoma
#11
Joni Leppänen, Sara Bogdanoff, Petri P Lehenkari, Juha Saarnio, Joonas H Kauppila, Tuomo J Karttunen, Heikki Huhta, Olli Helminen
BACKGROUND: Tenascin-C and fibronectin are adhesive glycoproteins modulating the structure of the extracellular matrix and cellular functions. Their expression and function in esophageal adenocarcinoma is poorly known. The aim of this study was to evaluate the expression of tenascin-C and fibronectin in esophageal adenocarcinoma and its precursor stages. RESULTS: Stromal tenascin-C and fibronectin expression were found in all evaluated lesion types. Expression of both molecules increased from gastric metaplasia towards adenocarcinoma (p<0...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28970723/high-yield-reproducible-rat-model-recapitulating-human-barrett-s-carcinogenesis
#12
Daisuke Matsui, Ashten N Omstead, Juliann E Kosovec, Yoshihiro Komatsu, Emily J Lloyd, Hailey Raphael, Ronan J Kelly, Ali H Zaidi, Blair A Jobe
AIM: To efficiently replicate the biology and pathogenesis of human esophageal adenocarcinoma (EAC) using the modified Levrat model of end-to-side esophagojejunostomy. METHODS: End-to-side esophagojejunostomy was performed on rats to induce gastroduodenoesophageal reflux to develop EAC. Animals were randomly selected and serially euthanized at 10 (n = 6), 17 (n = 8), 24 (n = 9), 31 (n = 6), 38 (n = 6), and 40 (n = 6) wk postoperatively. The esophagi were harvested for downstream histopathology and gene expression...
September 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28958906/impact-of-advanced-endoscopic-imaging-on-barrett-s-esophagus-in-daily-clinical-practice
#13
Sabina Beg, Mussa Mensa, Mark Fullard, Elizabeth Finerty, Paul Richman, Anthony Leahy
BACKGROUND AND AIMS: Several advanced imaging techniques have been proposed to improve the visualization of dysplastic regions within Barrett's epithelium, with some evidence for the use of narrow-band imaging (NBI) and acetic acid chromoendoscopy (AAC). METHODS: We retrospectively analyzed consecutive cases of Barrett's esophagus, diagnosed using white-light endoscopy and confirmed histologically by the presence of intestinal metaplasia, between April 2007 and April 2010 in a large community hospital...
September 25, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28922442/volumetric-laser-endomicroscopy-for-barrett-s-esophagus-looking-at-the-fine-print
#14
REVIEW
Deepanshu Jain, Sanna Fatima, Shilpa Jain, Shashideep Singhal
Barrett's esophagus (BE) is a premalignant condition. The incidence of adenocarcinoma in BE has been reported to be between 0.1-3%. Dysplasia in BE is patchy and extensive biopsy sampling is labor intensive, low yield and does not eliminate the sampling error completely. Volumetric laser endomicroscopy (VLE) is expected to enable endoscopists to do targeted biopsy of dysplastic/cancerous lesions (not visible on white light endoscopy) among patients with BE. We reviewed 7 studies with a total of 62 subjects who had undergone VLE...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28922414/a-nonrandomized-trial-of-vitamin-d-supplementation-for-barrett-s-esophagus
#15
MULTICENTER STUDY
Linda C Cummings, Prashanthi N Thota, Joseph E Willis, Yanwen Chen, Gregory S Cooper, Nancy Furey, Beth Bednarchik, Bronia M Alashkar, John Dumot, Ashley L Faulx, Stephen P Fink, Adam M Kresak, Basel Abusneineh, Jill Barnholtz-Sloan, Patrick Leahy, Martina L Veigl, Amitabh Chak, Sanford D Markowitz
BACKGROUND: Vitamin D deficiency may increase esophageal cancer risk. Vitamin D affects genes regulating proliferation, apoptosis, and differentiation and induces the tumor suppressor 15-hydroxyprostaglandin dehydrogenase (PGDH) in other cancers. This nonrandomized interventional study assessed effects of vitamin D supplementation in Barrett's esophagus (BE). We hypothesized that vitamin D supplementation may have beneficial effects on gene expression including 15-PGDH in BE. METHODS: BE subjects with low grade or no dysplasia received vitamin D3 (cholecalciferol) 50,000 international units weekly plus a proton pump inhibitor for 12 weeks...
2017: PloS One
https://www.readbyqxmd.com/read/28917343/long-term-outcomes-for-cryotherapy-in-barrett-s-esophagus-with-high-grade-dysplasia-just-cracking-the-ice
#16
EDITORIAL
Koushik K Das, Gary W Falk
No abstract text is available yet for this article.
October 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28917342/endoscopic-submucosal-dissection-in-endotherapy-for%C3%A2-barrett-s-esophagus-related-dysplasia-and-neoplasia-an%C3%A2-essential-or-optional-technique
#17
EDITORIAL
Prasad G Iyer
No abstract text is available yet for this article.
October 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28881904/human-papillomavirus-does-not-play-a-role-in-the-barrett-esophagus-a-french-cohort
#18
C Brochard, A Ducancelle, A Pivert, M Bodin, A Ricard, E Coron, C Couffon, N Dib, D Luet, N Musquer, M Le Rhun, S Bertrais, S Michalak, F Lunel-Fabiani, E Cesbron-Metivier, F X Caroli-Bosc
The role of human papillomavirus (HPV) in Barrett's esophagus (BE) has been examined but remains unclear. The purpose of the study is to dispute the connection between HPV and BE in a prospective case-control study. Biopsies were performed above and inside the Barrett's segment for BE patients and in the distal third of the esophagus for control patients for histological interpretation and for virological analysis. Biopsies for virological analysis were placed in a virus transport medium and immediately frozen in liquid nitrogen...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881901/digital-microscopy-as-valid-alternative-to-conventional-microscopy-for-histological-evaluation-of-barrett-s-esophagus-biopsies
#19
M J van der Wel, L C Duits, C A Seldenrijk, G J Offerhaus, M Visser, F J Ten Kate, O J de Boer, J G Tijssen, J J Bergman, S L Meijer
Management of Barrett's esophagus (BE) relies heavily on histopathological assessment of biopsies, associated with significant intra- and interobserver variability. Guidelines recommend biopsy review by an expert in case of dysplasia. Conventional review of biopsies, however, is impractical and does not allow for teleconferencing or annotations. An expert digital review platform might overcome these limitations. We compared diagnostic agreement of digital and conventional microscopy for diagnosing BE ± dysplasia...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28881898/performance-characteristics-of-optical-coherence-tomography-in-assessment-of-barrett-s-esophagus-and-esophageal-cancer-systematic-review
#20
D R Kohli, M L Schubert, A M Zfass, T U Shah
Optical coherence tomography (OCT) can generate high-resolution images of the esophagus that allows cross-sectional visualization of esophageal wall layers. We conducted a systematic review to assess the utility of OCT for diagnosing of esophageal intestinal metaplasia (IM; Barrett's esophagus BE)), dysplasia, cancer and staging of early esophageal cancer. English language human observational studies and clinical trials published in PubMed and Embase were included if they assessed any of the following: (i) in-vivo features and accuracy of OCT at diagnosing esophageal IM, sub-squamous intestinal metaplasia (SSIM), dysplasia, or cancer, and (ii) accuracy of OCT in staging esophageal cancer...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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