TITLE

Extent of Low-Grade Dysplasia Is a Risk Factor for the Development of Esophageal Adenocarcinoma in Barrett's Esophagus

AUTHOR(S)
Srivastava, Amitabh; Hornick, Jason L.; Xiaohong Li; Blount, Patricia L.; Sanchez, Carissa A.; Cowan, David S.; Ayub, Kamran; Maley, Carlo C.; Reid, Brian J.; Odze, Robert D.
PUB. DATE
March 2007
SOURCE
American Journal of Gastroenterology;Mar2007, Vol. 102 Issue 3, p483
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: Previous studies that evaluated extent of high-grade dysplasia (HGD) as a risk factor for esophageal adenocarcinoma (EA) in Barrett's esophagus (BE) were conflicting, and no prior study has evaluated extent of low-grade dysplasia (LGD) as a risk factor. The aim of this discovery study was to evaluate the hypothesis that extent of LGD and HGD are risk factors for progression to EA. METHODS: We evaluated baseline biopsies from 77 BE patients with dysplasia including 44 who progressed to EA and 33 who did not progress during follow-up. The total numbers of LGD and HGD crypts were determined separately by counting all crypts and the extent of LGD, HGD, and total dysplasia were correlated with EA outcome. RESULTS: Thirty-one and 46 patients had a maximum diagnosis of LGD and HGD, respectively. When the crypts were stratified by dysplasia grade, the mean number of LGD crypts per patient was borderline higher in progressors (93.9) compared with nonprogressors (41.2, P= 0.07), and the mean proportion of LGD crypts per patient was significantly higher in progressors (46.4% vs 26.0%, P= 0.037). Neither the mean number of HGD crypts per patient ( P= 0.14) nor the mean proportion of HGD crypts per patient ( P= 0.20) was significantly associated with EA outcome. CONCLUSIONS: The extent of LGD is a significant risk factor for the development of EA in BE in this study. Although the presence of HGD is significantly associated with a greater relative risk for development of EA, the extent of HGD was not an independent risk factor for progression.
ACCESSION #
24165559

 

Related Articles

  • Common Questions About Barrett Esophagus. ZIMMERMAN, THOMAS G. // American Family Physician;1/15/2014, Vol. 89 Issue 2, p92 

    Barrett esophagus is a precancerous metaplasia of the esophagus that is more common in patients with chronic reflux symptoms, although it also occurs in patients without symptomatic reflux. Other risk factors include smoking, male sex, obesity, white race, hiatal hernia, and increasing age...

  • Comparing Treatments for Barrett's Disease.  // Clinician Reviews;Jul2009, Vol. 19 Issue 7, p18 

    The article reports that endoscopic radiofrequency ablation (RFA) was shown to completely eradicate Barrett's esophagus with associated dysplasia. Seventy-seven percent of members of a U.S. registry of patients with Barrett's esophagus who received RFA procedures were found cured of the disease...

  • Toll-like receptor 9 expression in the natural history of Barrett mucosa. Huhta, Heikki; Helminen, Olli; Kauppila, Joonas; Takala, Heikki; Metsikkö, Kalervo; Lehenkari, Petri; Saarnio, Juha; Karttunen, Tuomo // Virchows Archiv;Jul2015, Vol. 467 Issue 1, p9 

    Increased expression of TLR9 in esophageal adenocarcinoma and squamous cell carcinoma correlates with poor prognosis. We have explored the expression and suspected that TLR9 activation might contribute to pathogenesis in esophageal columnar metaplasia-dysplasia-neoplasia sequence, and hence, we...

  • Barrett's oesophagus. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p91 

    An encyclopedia entry for "Barret's oesophagus" is presented. This disorder of the esophagus resulted from a complication of gastro-esophageal reflux in which the cells that line the lower part of the oesophagus are replaced by cells that are normally found in the stomach. People suffering from...

  • Barrett’s Esophagus, Fundoplication, and Cancer. Watson, David I.; Mayne, George C.; Hussey, Damian J. // World Journal of Surgery;Mar2007, Vol. 31 Issue 3, p447 

    The author reflects on the gastro-esophageal reflux and Barrett's esophagus. According to the author, gastro-esophageal reflux and Barrett's esophagus have become increasingly common in all Western countries, underpinning a 300-400% increase in the incidence of esophageal adenocarcinoma. The...

  • The Application of Prague C and M Criteria in the Diagnosis of Barrett's Esophagus in an Ethnic Chinese Population. Chi-Yang Chang; Yi-Chia Lee; Ching-Tai Lee; Chia-Hung Tu; Jau-C hung Hwang; Hung Chiang; Chi-Ming Tai; Tsung-H sien Chiang; Ming-Shiang Wu; Jaw-Town Lin // American Journal of Gastroenterology;Jan2009, Vol. 104 Issue 1, p13 

    OBJECTIVES: To investigate the prevalence of endoscopically suspected esophageal metaplasia (ESEM) in an ethnic Chinese population by endoscopic and pathologic evaluation and to assess the utility of Prague C and M criteria. METHODS: Consecutive patients who received esophagogastroduodenoscopy...

  • Barrett's Esophagus on Repeat Endoscopy: Should We Look More Than Once? Rodriguez, Sarah; Mattek, Nora; Lieberman, David; Fennerty, Brian; Eisen, Glenn // American Journal of Gastroenterology;Aug2008, Vol. 103 Issue 8, p1892 

    BACKGROUND: Barrett's esophagus (BE) is the precursor lesion for esophageal adenocarcinoma. The major risk factor for BE is chronic gastroesophageal reflux disease (GERD). Screening patients with longstanding GERD for BE with upper esophagogastroduodenoscopy (EGD) has become the standard...

  • Barrett's Esophagus.  // Current Medical Literature: Gastroenterology;2007, Vol. 26 Issue 3, p85 

    The article presents studies related to Barrett's esophagus. These include "Long-term survival following endoscopic and surgical treatment of high-grade dysplasia in Barrett's esophagus," by G. A. Prasad et al, and "Extent of low-grade dysplasia is a risk factor for the development of esophageal...

  • Barrett's Esophagus.  // Current Medical Literature: Gastroenterology;2008, Vol. 27 Issue 3, p92 

    The article highlights studies related to Barrett's esophagus. In "Is the Risk of Concomitant Invasive Esophageal Cancer in High-Grade Dysplasia in Barrett's Esophagus Overestimated?," the authors concluded that the true prevalence of invasive cancer in patients with BE and HGD has been greatly...

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