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Barrett's oesophagus

David Graham, Gideon Lipman, Vinay Sehgal, Laurence B Lovat
The landscape for patients with Barrett's oesophagus (BE) has changed significantly in the last decade. Research and new guidelines have helped gastroenterologists to better identify those patients with BE who are particularly at risk of developing oesophageal adenocarcinoma. In parallel, developments in endoscopic image enhancement technology and optical biopsy techniques have improved our ability to detect high-risk lesions. Once these lesions have been identified, the improvements in minimally invasive endoscopic therapies has meant that these patients can potentially be cured of early cancer and high-risk dysplastic lesions without the need for surgery, which still has a significant morbidity and mortality...
October 2016: Frontline Gastroenterology
Samuel Torres-Landa, Janette Furuzawa-Carballeda, Enrique Coss-Adame, Miguel A Valdovinos, Edgar Alejandro-Medrano, Bárbara Ramos-Ávalos, Braulio Martínez-Benítez, Gonzalo Torres-Villalobos
The aim of the study was to characterize the presence of diverse CD4 and CD8 T cell subsets and regulatory cells in peripheral blood and lower oesophageal sphincter (LES) from a young patient with BE/achalasia without treatment versus achalasia group. In order to characterize the circulating cells in this patient, a cytometric analysis was performed. LES tissue was evaluated by double-immunostaining procedure. Five healthy blood donors, 5 type achalasia patients, and 5 oesophagus tissue samples (gastrooesophageal junction) from transplant donors were included as control groups...
2016: Case Reports in Gastrointestinal Medicine
E Werbrouck, G De Hertogh, X Sagaert, G Coremans, H Willekens, I Demedts, R Bisschops
BACKGROUND: Endoscopic resection (ER) with or without ablation is the first choice treatment for early Barrett's neoplasia. Adequate staging is important to assure a good oncological outcome. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of pre-operative biopsies in patients who undergo ER for high-grade dysplasia (HGD) or early adenocarcinoma (EAC) in Barrett's oesophagus (BE) and the cardia. METHODS: Between November 2005-May 2012, 142 ERs performed in 137 patients were obtained...
October 2016: United European Gastroenterology Journal
Angela Bureo Gonzalez, Jacques Jghm Bergman, Roos E Pouw
Barrett's oesophagus is a precursor lesion for oesophageal adenocarcinoma, which generally has a poor prognosis. Patients diagnosed with Barrett's oesophagus therefore undergo regular endoscopic surveillance to detect neoplastic lesions at a curable stage. The efficacy of endoscopic surveillance of Barrett's oesophagus patients is, however, hampered by difficulties to detect early neoplasia endoscopically, biopsy sampling error, inter-observer variability in histological assessment and the relatively low overall progression rate...
October 2016: United European Gastroenterology Journal
O J Old, G R Lloyd, J Nallala, M Isabelle, L M Almond, N A Shepherd, C A Kendall, A C Shore, H Barr, N Stone
Barrett's oesophagus (BE) is a premalignant condition that can progress to oesophageal adenocarcinoma. Endoscopic surveillance aims to identify potential progression at an early, treatable stage, but generates large numbers of tissue biopsies. Fourier transform infrared (FTIR) mapping was used to develop an automated histology tool for detection of BE and Barrett's neoplasia in tissue biopsies. 22 oesophageal tissue samples were collected from 19 patients. Contiguous frozen tissue sections were taken for pathology review and FTIR imaging...
October 7, 2016: Analyst
David C Whiteman, Bradley J Kendall
Barrett's oesophagus is a condition characterised by partial replacement of the normal squamous epithelium of the lower oesophagus by a metaplastic columnar epithelium containing goblet cells (intestinal metaplasia). Barrett's oesophagus is important clinically because those afflicted are predisposed to oesophageal adenocarcinoma. Prevalence surveys suggest that up to 2% of the population may be affected; most will be unaware of their diagnosis. Risk factors include age, male sex, gastro-oesophageal acid reflux, central obesity and smoking...
October 3, 2016: Medical Journal of Australia
Birgitte-Elise G Emken, Lars R Lundell, Lene Wallin, Helge E Myrvold, Cecilia Engström, Madeleine Montgomery, Anders R Malm, Tore Lind, Jan G Hatlebakk
OBJECTIVE: To compare the effect of anti-reflux surgery (ARS) versus proton pump inhibitor therapy on lower oesophageal sphincter (LOS) function and oesophageal acid exposure in patients with chronic gastro-oesophageal reflux disease (GORD) over a decade of follow-up. MATERIAL AND METHODS: In this randomised, prospective, multicentre study we compared LOS pressure profiles, as well as oesophageal exposure to acid, at baseline and at 1 and 10 years after randomisation to either open ARS (n = 137) or long-term treatment with omeprazole (OME) 20-60 mg daily (n = 108)...
September 3, 2016: Scandinavian Journal of Gastroenterology
Shane P Duggan, Fiona M Behan, Murat Kirca, Abdul Zaheer, Sarah A McGarrigle, John V Reynolds, Gisela M F Vaz, Mathias O Senge, Dermot Kelleher
Barrett's oesophagus (BO), an intestinal-type metaplasia (IM), typically arising in conjunction with gastro-oesophageal reflux disease, is a prominent risk factor for the development of oesophageal adenocarcinoma (OAC). The molecular similarities between IM and normal intestinal tissues are ill-defined. Consequently, the contribution of intestine-enriched factors expressed within BO to oncogenesis is unclear. Herein, using transcriptomics we define the intestine-enriched genes expressed in meta-profiles of BO and OAC...
2016: Scientific Reports
Christine Royston, Christine Caygill, Andre Charlett, Karna Dev Bardhan
INTRODUCTION: We present the long-term outcome of Barrett's oesophagus (BO) at a District General Hospital set against the increasing numbers of patients with gastro-oesophageal reflux disease (GORD). METHODS: Data were collected prospectively over 37 years. Comparison of GORD without Barrett's (NoBO) versus BO was performed from 1/1/1977 to 31/12/2001 when the NoBO database closed and outcomes of all cases of BO diagnosed until 31/12/2011 and followed up until 31/12/2013 have been reported...
August 26, 2016: European Journal of Gastroenterology & Hepatology
K Visrodia, S Singh, R Krishnamoorthi, D A Ahlquist, K K Wang, P G Iyer, D A Katzka
BACKGROUND: The proportion of oesophageal adenocarcinoma that is detected concurrently with initial Barrett's oesophagus diagnosis is not well studied. AIM: To compare the proportion of prevalent adenocarcinoma vs. incident adenocarcinoma found during surveillance of Barrett's. METHODS: We performed a systematic search of MEDLINE, EMBASE and Web of Science (from their inception to 31 May 2015) for cohort studies in adults with Barrett's (nondysplastic Barrett's ± Barrett's with low-grade dysplasia) with minimum average follow-up of 3 years, and providing numbers of prevalent adenocarcinoma detected (concurrently with Barrett's diagnosis and up to 1 year afterwards) vs...
October 2016: Alimentary Pharmacology & Therapeutics
Pierre Martinez, Margriet R Timmer, Chiu T Lau, Silvia Calpe, Maria Del Carmen Sancho-Serra, Danielle Straub, Ann-Marie Baker, Sybren L Meijer, Fiebo J W Ten Kate, Rosalie C Mallant-Hent, Anton H J Naber, Arnoud H A M van Oijen, Lubbertus C Baak, Pieter Scholten, Clarisse J M Böhmer, Paul Fockens, Jacques J G H M Bergman, Carlo C Maley, Trevor A Graham, Kausilia K Krishnadath
Surveillance of Barrett's oesophagus allows us to study the evolutionary dynamics of a human neoplasm over time. Here we use multicolour fluorescence in situ hybridization on brush cytology specimens, from two time points with a median interval of 37 months in 195 non-dysplastic Barrett's patients, and a third time point in a subset of 90 patients at a median interval of 36 months, to study clonal evolution at single-cell resolution. Baseline genetic diversity predicts progression and remains in a stable dynamic equilibrium over time...
2016: Nature Communications
John M Findlay, Mark R Middleton, Ian Tomlinson
Barrett's oesophagus (BO) is a common condition, predisposing strongly to the development of oesophageal adenocarcinoma (OAC). Consequently, there has been considerable effort to determine the processes involved in the development of BO metaplasia, and ultimately develop markers of patients at risk. Whilst a number of robust acquired risk factors have been identified, a genetic component to these and the apparent increased susceptibility of certain individuals has long been suspected. This has been evidenced in part by linkage studies, but subsequently two recent genome-wide association studies (GWAS) have suggested mechanisms underlying the heritability of BO, as well as providing the first direct evidence at modern levels of statistical significance...
August 2016: United European Gastroenterology Journal
Stephen J Meltzer
No abstract text is available yet for this article.
October 2016: Lancet Oncology
Puya Gharahkhani, Rebecca C Fitzgerald, Thomas L Vaughan, Claire Palles, Ines Gockel, Ian Tomlinson, Matthew F Buas, Andrea May, Christian Gerges, Mario Anders, Jessica Becker, Nicole Kreuser, Tania Noder, Marino Venerito, Lothar Veits, Thomas Schmidt, Hendrik Manner, Claudia Schmidt, Timo Hess, Anne C Böhmer, Jakob R Izbicki, Arnulf H Hölscher, Hauke Lang, Dietmar Lorenz, Brigitte Schumacher, Andreas Hackelsberger, Rupert Mayershofer, Oliver Pech, Yogesh Vashist, Katja Ott, Michael Vieth, Josef Weismüller, Markus M Nöthen, Stephen Attwood, Hugh Barr, Laura Chegwidden, John de Caestecker, Rebecca Harrison, Sharon B Love, David MacDonald, Paul Moayyedi, Hans Prenen, R G Peter Watson, Prasad G Iyer, Lesley A Anderson, Leslie Bernstein, Wong-Ho Chow, Laura J Hardie, Jesper Lagergren, Geoffrey Liu, Harvey A Risch, Anna H Wu, Weimin Ye, Nigel C Bird, Nicholas J Shaheen, Marilie D Gammon, Douglas A Corley, Carlos Caldas, Susanne Moebus, Michael Knapp, Wilbert H M Peters, Horst Neuhaus, Thomas Rösch, Christian Ell, Stuart MacGregor, Paul Pharoah, David C Whiteman, Janusz Jankowski, Johannes Schumacher
BACKGROUND: Oesophageal adenocarcinoma represents one of the fastest rising cancers in high-income countries. Barrett's oesophagus is the premalignant precursor of oesophageal adenocarcinoma. However, only a few patients with Barrett's oesophagus develop adenocarcinoma, which complicates clinical management in the absence of valid predictors. Within an international consortium investigating the genetics of Barrett's oesophagus and oesophageal adenocarcinoma, we aimed to identify novel genetic risk variants for the development of Barrett's oesophagus and oesophageal adenocarcinoma...
October 2016: Lancet Oncology
Manjulika Das
No abstract text is available yet for this article.
September 2016: Lancet Oncology
Matthew F Buas, Qianchuan He, Lisa G Johnson, Lynn Onstad, David M Levine, Aaron P Thrift, Puya Gharahkhani, Claire Palles, Jesper Lagergren, Rebecca C Fitzgerald, Weimin Ye, Carlos Caldas, Nigel C Bird, Nicholas J Shaheen, Leslie Bernstein, Marilie D Gammon, Anna H Wu, Laura J Hardie, Paul D Pharoah, Geoffrey Liu, Prassad Iyer, Douglas A Corley, Harvey A Risch, Wong-Ho Chow, Hans Prenen, Laura Chegwidden, Sharon Love, Stephen Attwood, Paul Moayyedi, David MacDonald, Rebecca Harrison, Peter Watson, Hugh Barr, John deCaestecker, Ian Tomlinson, Janusz Jankowski, David C Whiteman, Stuart MacGregor, Thomas L Vaughan, Margaret M Madeleine
OBJECTIVE: Oesophageal adenocarcinoma (OA) incidence has risen sharply in Western countries over recent decades. Local and systemic inflammation is considered an important contributor to OA pathogenesis. Established risk factors for OA and its precursor, Barrett's oesophagus (BE), include symptomatic reflux, obesity and smoking. The role of inherited genetic susceptibility remains an area of active investigation. Here, we explore whether germline variation related to inflammatory processes influences susceptibility to BE/OA...
August 2, 2016: Gut
Nadeem O Kaakoush, Margaret J Morris
The influence of diets rich in saturated fats and simple sugars on the intestinal microbiota plays a central role in obesity. Being overweight or obese predisposes individuals to several diseases including oesophageal adenocarcinoma (OAC), which develops through a cascade of events starting with gastro-oesophageal reflux disease, progressing to Barrett's oesophagus (BO), and then OAC. A range of mechanisms for the increased risk of OAC in obese individuals have been proposed; however, a role for the oesophageal microbiota has been largely ignored...
October 2016: FEMS Microbiology Ecology
Eleanor M Gregson, Jan Bornschein, Rebecca C Fitzgerald
Barrett's oesophagus (BE) is the premalignant condition associated with the development of oesophageal adenocarcinoma (OAC). Diagnostically, p53 immunohistochemistry remains the only biomarker recommended clinically to aid histopathological diagnosis. The emerging mutational profile of BE is one of highly heterogeneous lesions at the genomic level with many mutations already occurring in non-dysplastic tissue. As well as point mutations, larger scale copy-number changes appear to have a key role in the progression to OAC and clinically applicable assays for the reliable detection of aneuploidy will be important to incorporate into future clinical management of patients...
August 9, 2016: British Journal of Cancer
Stefano Bibbò, Gianluca Ianiro, Riccardo Ricci, Damiano Arciuolo, Lucio Petruzziello, Cristiano Spada, Alberto Larghi, Maria Elena Riccioni, Antonio Gasbarrini, Guido Costamagna, Giovanni Cammarota
BACKGROUND: A careful endoscopic surveillance of Barrett's oesophagus is warranted to prevent esophageal cancer. AIM: To identify the preferred location of non-circumferential Barrett's oesophagus and associated dysplasia within the esophageal circumference. METHODS: We retrospectively reviewed a prospectively maintained database of patients with non-circumferential lesions. The location of metaplastic lesions and dysplastic lesions within the esophageal circumference was identified as on a clock face, and their distribution in the 4 quadrants was compared...
September 2016: Digestive and Liver Disease
Daniela Zanotti, Mohamed Elkalaawy, Majid Hashemi, Andrew Jenkinson, Marco Adamo
PURPOSE: Preoperative oesophago-gastro-duodenoscopy (p-OGD) is often routinely employed in patients undergoing bariatric surgery. The value of p-OGD is still unclear; however, since all bariatric procedures modify stomach anatomy differently with exclusion of the remnant in a majority of cases, the question arises whether there is a rational for including it routinely in the preoperative pathway. MATERIAL AND METHODS: To assess the current status of p-OGD in the UK, a survey was sent to the British Obesity & Metabolic Surgery Society members, regarding preoperative evaluation of patients, focusing on the role of p-OGD...
September 2016: Obesity Surgery
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