TITLE

High-Frequency Probe Ultrasonography Has Limited Accuracy for Detecting Invasive Adenocarcinoma in Patients with Barrett's Esophagus and High-Grade Dysplasia or Intramucosal Carcinoma: A Case Series

AUTHOR(S)
Waxman, Irving; Raju, Gottumukkala S.; Critchlow, Jonathan; Antonioli, Donald A.; Spechler, Stuart Jon
PUB. DATE
August 2006
SOURCE
American Journal of Gastroenterology;Aug2006, Vol. 101 Issue 8, p1773
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
AIM: To evaluate prospectively the accuracy of preoperative high-frequency (20 MHz) probe ultrasonography (HFPUS) for detecting invasive cancer in patients referred for esophagectomy because of an endoscopic biopsy diagnosis of high-grade dysplasia (HGD) or intramucosal carcinoma (ICA) in Barrett's esophagus (BE). PATIENTS AND METHODS: Nine consecutive male patients (median age of 69 yr) who were referred for esophagectomy for HGD or ICA in BE agreed to participate. We performed conventional upper gastrointestinal endoscopy followed by HFPUS using a through-the-scope ultrasound probe (20 MHz), and we compared our preoperative findings with the pathologist's findings in the resected esophageal specimens. RESULTS: There was complete agreement between the postoperative pathological findings and the preoperative HFPUS findings in only 4 of the 9 patients. HFPUS resulted in two false-negative diagnoses of esophageal cancer (both had T1 lesions in the resected specimens), one false-positive diagnosis of esophageal cancer, and two errors in tumor staging (1 understaged, 1 overstaged). CONCLUSIONS: HFPUS has limited accuracy for identifying invasive cancer in patients found to have HGD or IMC in BE. Pending further refinements in technology, clinical management decisions in such patients should not be based solely on the results of HFPUS.
ACCESSION #
21785071

 

Related Articles

  • Surgical Management of High-Grade Dysplasia in Barrett's Esophagus. Rice, Thomas W.; Falk, Gary W.; Achkar, Edgar; Petras, Robert E. // American Journal of Gastroenterology;Nov1993, Vol. 88 Issue 11, p1832 

    The role of surgery in patients with Barrett's esophagus and high-grade dysplasia is controversial. The aims of this study were to determine the prevalence of unsuspected early cancer and to evaluate surgical outcome in a cohort of patients with high-grade dysplasia. Records of all 16 patients...

  • Cytokeratin phenotyping does not help in distinguishing oesophageal adenocarcinoma from cancer of the gastric cardia. Van Lier, M. G. F.; Bomhof, F. J.; Leenclertse, I.; Flens, M.; Balk, A. I.; Loffeld, R. J. L. F. // Journal of Clinical Pathology;Jul2005, Vol. 58 Issue 7, p722 

    Background: It is sometimes difficult to distinguish between cardia cancer and oesophageal cancer. Aims: To evaluate whether cytokeratin (CK) expression of the tumour can be of value in differentiating between the two tumour types. Methods: Consecutive patients with a malignant tumour in the...

  • Exome and whole-genome sequencing of esophageal adenocarcinoma identifies recurrent driver events and mutational complexity. Dulak, Austin M; Stojanov, Petar; Peng, Shouyong; Lawrence, Michael S; Fox, Cameron; Stewart, Chip; Bandla, Santhoshi; Imamura, Yu; Schumacher, Steven E; Shefler, Erica; McKenna, Aaron; Carter, Scott L; Cibulskis, Kristian; Sivachenko, Andrey; Saksena, Gordon; Voet, Douglas; Ramos, Alex H; Auclair, Daniel; Thompson, Kristin; Sougnez, Carrie // Nature Genetics;May2013, Vol. 45 Issue 5, p478 

    The incidence of esophageal adenocarcinoma (EAC) has risen 600% over the last 30 years. With a 5-year survival rate of ∼15%, the identification of new therapeutic targets for EAC is greatly important. We analyze the mutation spectra from whole-exome sequencing of 149 EAC tumor-normal pairs,...

  • Staging investigations for oesophageal cancer: a meta-analysis. van Vliet, E. P. M.; Heijenbrok-Kal, M. H.; Hunink, M. G. M.; Kuipers, E. J.; Siersema, P. D. // British Journal of Cancer;2/5/2008, Vol. 98 Issue 3, p547 

    The aim of the study was to compare the diagnostic performance of endoscopic ultrasonography (EUS), computed tomography (CT), and 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in staging of oesophageal cancer. PubMed was searched to identify English-language articles...

  • Role of retinoid X receptor mRNA expression in Barrett's esophagus Brabender, Jan; Lord, Reginald V.; Metzger, Ralf; Park, JiMin; Salonga, Dennis; Danenberg, Kathleen D.; Hölscher, Arnulf H.; Danenberg, Peter V.; Schneider, Paul M.; Hölscher, Arnulf H // Journal of Gastrointestinal Surgery;May2004, Vol. 8 Issue 4, p413 

    The Barrett''s multistage process is characterized histopathologically by progression from Barrett''s intestinal metaplasia to Barrett''s esophagus with dysplasia and ultimately adenocarcinoma. Understanding of the molecular alterations in this multistage process may contribute to improved...

  • Esophageal Adenocarcinoma Associated with Barrett's Esophagus: Long--term Management with Laser Ablation. Ertan, Atilla; Zimmerman, Michael; Younes, Mamoun // American Journal of Gastroenterology;Dec1995, Vol. 90 Issue 12, p2201 

    We report the use of neodymium:yttrium-aluminum-garnet (Nd:YAG) laser ablation to treat high-grade dysplasia and intramucosal esophageal adenocarcinoma associated with Barrett's esophagus in a patient who refused surgery. Throughout laser therapy, the patient received omeprazole 40 mg/day. After...

  • Intrabile duct metastasis from colonic adenocarcinoma without liver parenchyma involvement: contrast enhanced ultrasonography detection. Ghittoni, Giorgia; Caturelli, Eugenio; Viera, Francesca; Viera, Francesca Torello // Abdominal Imaging;Jun2010, Vol. 35 Issue 3, p346 

    It is well-known that biliary duct invasion with intraluminal growth is one of the developmental patterns of primary liver tumors, and macroscopic intrabiliary growth of liver metastases in colorectal cancer is found with high frequency. Surgical treatment is the only potential curative therapy....

  • Cancer Cell: Scientists link 2 cancer-promoting pathways in esophageal cancer.  // Biomedical Market Newsletter;3/21/2012, Vol. 21, p1 

    The article offers information on the identification of cancer promoting pathways responsible for esophageal cancer along with mechanism of drug action for prevention of esophageal cancer.

  • MiR-145 Expression Accelerates Esophageal Adenocarcinoma Progression by Enhancing Cell Invasion and Anoikis Resistance. Derouet, Mathieu Francois; Liu, Geoffrey; Darling, Gail Elizabeth // PLoS ONE;Dec2014, Vol. 9 Issue 12, p1 

    Background: Carcinoma of the esophagus has a high case fatality ratio and is now the 6th most common cause of cancer deaths in the world. We previously conducted a study to profile the expression of miRNAs in esophageal adenocarcinoma (EAC) pre and post induction therapy. Of the miRNAs...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics