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Dysplasia in Barrett's esophagus

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https://www.readbyqxmd.com/read/28551084/barrett-s-esophagus-ten-years-of-experience-at-a-tertiary-care-hospital-center-in-mexico
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28446978/optimizing-the-diagnosis-and-therapy-of-barrett-s-esophagus
#11
REVIEW
Juan A Muñoz-Largacha, Hiran C Fernando, Virginia R Litle
The incidence of Barrett's esophagus (BE) in the Western world has increased over the last decades. BE is considered a premalignant lesion that can progress to esophageal adenocarcinoma (EAC), a highly aggressive malignancy with poor survival rates. The close association between BE and EAC highlights the need for an early diagnosis in order to improve survival and outcomes in this group of patients. Although the evidence for BE screening with conventional endoscopy is controversial and limited by cost-effectiveness studies, screening can be suggested in patients with chronic gastroesophageal reflux disease (GERD) and two or more risk factors for EAC...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28440661/morphological-features-and-prognostic-significance-of-arid1a-deficient-esophageal-adenocarcinomas
#12
Michael G Drage, Mingkhwan Tippayawong, Agoston T Agoston, Yifan Zheng, Raphael Bueno, Jason L Hornick, Robert D Odze, Amitabh Srivastava
CONTEXT: - The clinicopathologic and prognostic significance of ARID1A mutation in esophageal adenocarcinoma (EAC) is unknown. OBJECTIVE: - To determine the morphological correlates and prognostic significance of ARID1A-deficient EAC. DESIGN: - One hundred twenty cases of primary EAC were evaluated for a predetermined set of histologic features and immunohistochemistry for ARID1A, p53, and MLH1 performed on EAC, as well as adjacent Barrett esophagus and Barrett esophagus-associated dysplasia, when feasible...
April 25, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28432477/usefulness-of-non-magnifying-narrow-band-imaging-in-evis-exera-iii-video-systems-and-high-definition-endoscopes-to-diagnose-dysplasia-in-barrett-s-esophagus-using-the-barrett-international-nbi-group-bing-classification
#13
Oscar Nogales, Arancha Caballero-Marcos, Ana Clemente-Sánchez, Javier García-Lledó, Leticia Pérez-Carazo, Beatriz Merino, Carlos Carbonell, María López-Ibáñez, Cecilia González-Asanza
BACKGROUND: Narrow band imaging (NBI) allows identification of abnormal areas of Barrett's esophagus (BE) and could facilitate targeted biopsies. AIMS: We evaluated the diagnostic accuracy for dysplasia prediction using non-magnifying NBI in Evis Exera III processors and high-definition endoscopes using the Barrett International NBI Group (BING) classification, as well as inter/intraobserver agreement for dysplasia prediction and mucosal/vascular patterns. METHODS: Eight observers (4 staff endoscopists and 4 trainee endoscopists) evaluated 100 images selected from an anonymized bank of 470 photographs using the BING classification...
April 21, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#14
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28405317/changes-in-gene-expression-of-neo-squamous-mucosa-after-endoscopic-treatment-for-dysplastic-barrett-s-esophagus-and-intramucosal-adenocarcinoma
#15
Angelique Levert-Mignon, Michael J Bourke, Sarah J Lord, Andrew C Taylor, Antony R Wettstein, Melanie Edwards, Natalia K Botelho, Rebecca Sonson, Chatura Jayasekera, Oliver M Fisher, Melissa L Thomas, Finlay Macrae, Damian J Hussey, David I Watson, Reginald V Lord
BACKGROUND: Endoscopic therapy, including by radiofrequency ablation (RFA) or endoscopic mucosal resection (EMR), is first line treatment for Barrett's esophagus (BE) with high-grade dysplasia (HGD) or intramucosal cancer (IMC) and may be appropriate for some patients with low-grade dysplasia (LGD). OBJECTIVE: The purpose of this study was to investigate the molecular effects of endotherapy. METHODS: mRNA expression of 16 genes significantly associated with different BE stages was measured in paired pre-treatment BE tissues and post-treatment neo-squamous biopsies from 36 patients treated by RFA (19 patients, 3 IMC, 4 HGD, 12 LGD) or EMR (17 patients, 4 IMC, 13 HGD)...
February 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28402993/volumetric-laser-endomicroscopy-in-the-management-of-barrett-s-esophagus
#16
Arvind J Trindade, Cadman L Leggett, Kenneth J Chang
PURPOSE OF REVIEW: The incidence of esophageal adenocarcinoma is on the rise despite widespread appreciation that the precursor lesion is Barrett's esophagus. Studies have shown that some patients known to have Barrett's esophagus develop cancer despite their enrollment in conventional endoscopic surveillance programs. This highlights the need for advanced endoscopic imaging to help identify early neoplasia and prevent its progression to esophageal cancer. Recently, a wide-field, second-generation optical coherence tomography endoscopic platform called volumetric laser endomicroscopy (VLE) was cleared by the Food and Drug Administration and made commercially available for advanced imaging in Barrett's esophagus...
April 11, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28399610/dedicated-barrett-s-surveillance-sessions-managed-by-trained-endoscopists-improve-dysplasia-detection-rate
#17
Joanne Ooi, Patrick Wilson, Giles Walker, Paul Blaker, Sabina DeMartino, John O'Donohue, David Reffitt, Effie Lansepre, Fuju Chang, John Meenan, Jason M Dunn
Background and study aim Barrett's esophagus (BE)-associated dysplasia is an important marker for risk of progression to esophageal adenocarcinoma (EAC) and an indication for endoscopic therapy. However, BE surveillance technique is variable. The aim of this study was to assess the effect of dedicated BE surveillance lists on dysplasia detection rate (DDR). Patients and methods This was a prospective study of patients undergoing BE surveillance at two hospitals - community (UHL) and upper gastrointestinal center (GSTT)...
April 11, 2017: Endoscopy
https://www.readbyqxmd.com/read/28374819/disease-progression-in-barrett-s-low-grade-dysplasia-with-radiofrequency-ablation-compared-with-surveillance-systematic-review-and-meta-analysis
#18
REVIEW
Bashar J Qumseya, Sachin Wani, Sherif Gendy, Ben Harnke, Jacques J Bergman, Herbert Wolfsen
OBJECTIVES: Barrett's esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC). Management of BE with low-grade dysplasia continues to be controversial. We aimed to conduct a systematic review and meta-analysis comparing the risk of progression to high-grade dysplasia or EAC among patients with BE with low-grade dysplasia treated with radiofrequency ablation (RFA) compared with surveillance endoscopy. METHODS: Our search included Medline, Embase, and Cochrane Central, was limited to English language articles, and was last searched on 31 December 2015...
April 4, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28374815/the-impact-of-a-prior-diagnosis-of-barrett-s-esophagus-on-esophageal-adenocarcinoma-survival
#19
Angela C Tramontano, Deirdre F Sheehan, Jennifer M Yeh, Chung Yin Kong, Emily C Dowling, Joel H Rubenstein, Julian A Abrams, John M Inadomi, Deborah Schrag, Chin Hur
OBJECTIVES: Endoscopic surveillance of patients with Barrett's Esophagus (BE) is recommended to detect esophageal adenocarcinoma (EAC) and its dysplasia precursors, but survival benefits are unclear. Using Surveillance, Epidemiology, and End Results (SEER) and linked Medicare data, we sought to determine the impact of a prior BE diagnosis on survival in patients with EAC. METHODS: Our analysis focused on patients over age 65 with primary EAC diagnosed in a SEER region from 2000-2011 and enrolled in Medicare...
April 4, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28374813/predictors-of-progression-in-barrett-s-esophagus-with-low-grade-dysplasia-results-from-a-multicenter-prospective-be-registry
#20
Rajesh Krishnamoorthi, Jason T Lewis, Murli Krishna, Nicholas J Crews, Michele L Johnson, Ross A Dierkhising, Brenda F Ginos, Kenneth K Wang, Herbert C Wolfsen, David E Fleischer, Francisco C Ramirez, Navtej S Buttar, David A Katzka, Prasad G Iyer
OBJECTIVES: Low-grade dysplasia (LGD) is a risk factor for progression in Barrett's esophagus (BE). Progression estimates however vary and predictors of progression are not well established. We aimed to assess predictors of progression in a multicenter BE-LGD cohort. METHODS: All subjects with LGD (diagnosed by a GI pathologist) in a prospective BE registry were identified. Progression was defined development of HGD/EAC more than 12 months after index date of LGD diagnosis...
April 4, 2017: American Journal of Gastroenterology
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