TITLE

Extent of Low-Grade Dysplasia in Barrett's Esophagus: Is It Useful for Risk Stratification?

AUTHOR(S)
Falk, Gary W.; Goldblum, John R.
PUB. DATE
March 2007
SOURCE
American Journal of Gastroenterology;Mar2007, Vol. 102 Issue 3, p494
SOURCE TYPE
Academic Journal
DOC. TYPE
Editorial
ABSTRACT
Low-grade dysplasia remains one of the great enigmas of Barrett's esophagus. Limited information is available on the natural history of this lesion, and studies suggest that cancer risk in patients with low-grade dysplasia is intermediate between that of intestinal metaplasia without dysplasia and high-grade dysplasia. Natural history studies of low-grade dysplasia are hampered by problems with interobserver variability among pathologists and sampling variability among endoscopists. To date, the extent of low-grade dysplasia has not been examined as a potential risk factor for the subsequent development of adenocarcinoma. Srivastava et al., in this issue of the American Journal of Gastroenterology, found that the extent of low-grade dysplasia, as measured by several different methods, was a risk factor for progression to cancer. While these findings are novel and provocative, it is premature to request your pathologist to count the number of crypts or biopsies with low-grade dysplasia just yet. However, these findings, if confirmed by studies utilizing a simpler measure of the extent of low-grade dysplasia, may help us determine the prognostic significance of this lesion in the future.
ACCESSION #
24165560

 

Related Articles

  • The Munich Barrett follow up study: suspicion of Barrett's oesophagus based on either endoscopy or histology only-what is the clinical significance? Meining, A.; Ott, R.; Becker, I.; Hahn, S.; Mühlen, J.; Werner, M.; Höfler, H.; Classen, M.; Heidwein, W.; Rösch, T. // Gut;Oct2004, Vol. 53 Issue 10, p1402 

    Background: The incidence of distal oesophageal adenocarcinoma is rising, with chronic reflux and Barrett's oesophagus being considered risk factors. Reliable detection of Barrett's oesophagus during upper endoscopy is therefore mandatory but requires both endoscopy and histology for...

  • Posters.  // Annals of Oncology;Jun2012 Supplement 4, Vol. 23 Issue suppl_4, piv31 

    No abstract available.

  • The Incidence of Esophageal Cancer and High-Grade Dysplasia in Barretts Esophagus: A Systematic Review and Meta-Analysis. Fouad Yousef; Chris Cardwell; Marie M. Cantwell; Karen Galway; Brian T. Johnston; Liam Murray // American Journal of Epidemiology;Aug2008, Vol. 168 Issue 3, p237 

    Barretts esophagus is a well-recognized precursor of esophageal adenocarcinoma. Surveillance of Barretts esophagus patients is recommended to detect high-grade dysplasia (HGD) or early cancer. Because of wide variation in the published cancer incidence in Barretts esophagus, the authors...

  • Esophagectomy--It's Not Just About Mortality Anymore: Standardized Perioperative Clinical Pathways Improve Outcomes in Patients with Esophageal Cancer. Low, Donald E.; Kunz, Sonia; Schembre, Drew; Otero, Henry; Malpass, Tom; Hsi, Alex; Song, Guobin; Hinke, Richard; Kozarek, Richard A. // Journal of Gastrointestinal Surgery;Nov2007, Vol. 11 Issue 11, p1396 

    Background Esophageal resection (ER) remains the standard therapy for early esophageal cancer; however, because of concerns regarding high levels of morbidity and mortality reported in analyses of national databases, many patients are relegated to less effective endoscopic or chemotherapeutic...

  • Esophageal Adenocarcinoma in Barrett's Esophagus After Endoscopic Ablative Therapy: A Meta-Analysis and Systematic Review. Wani, Sachin; Puli, Srinivas R; Shaheen, Nicholas J; Westhoff, Brenda; Slehria, Sanjeev; Bansal, Ajay; Rastogi, Amit; Sayana, Hari; Sharma, Prateek // American Journal of Gastroenterology;Feb2009, Vol. 104 Issue 2, p502 

    OBJECTIVES:The extent of reduction of esophageal adenocarcinoma (EAC) incidence in Barrett's esophagus (BE) patients after endoscopic ablation is not known. The objective of this study was to determine the cancer incidence in BE patients after ablative therapy and compare these rates to cohort...

  • Management of Barrett's Esophagus. VELANOVICH, VIC // American Surgeon;Nov2012, Vol. 78 Issue 11, p1193 

    Barrett's esophagus is a pathologic change of the normal squamous epithelium of the esophagus to specialized columnar metaplasia. Barrett's esophagus is a result of prolonged exposure of the esophagus to gastroduodenal refluxate. Although Barrett's itself is not symptomatic, and, in fact,...

  • Endoscopic management of high-grade dysplasia and intramucosal carcinoma: experience in a large academic medical center. Perry, Kyle; Walker, Jon; Salazar, Mario; Suzo, Andrew; Hazey, Jeffrey; Melvin, W. // Surgical Endoscopy;Mar2014, Vol. 28 Issue 3, p777 

    Background: Esophagectomy has been the standard treatment for Barrett's esophagus (BE) with high-grade dysplasia (HGD) and intramucosal cancer (IMC). Recently, endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) have become the preferred treatment for these patients in some...

  • Toll-like receptors in esophageal cancer. Kauppila, Joonas H.; Selander, Katri S. // Frontiers in Immunology;May2014, Vol. 5, p1 

    Esophageal squamous cell carcinoma and esophageal adenocarcinoma are cancers of high mortality. EAC develops through Barrett's esophagus (BE) and columnar dysplasia, preceded by gastro-esophageal reflux disease. The risk of esophageal squamous cell carcinoma is increased by smoking and alcohol...

  • Metastatic melanoma in an esophagus demonstrating Barrett esophagus with high grade dysplasia. Trembath, Dimitri G.; Shaheen, Nicholas J.; O'Neill, Stacey; Weck, Karen; Greene, Kevin G. // BMC Research Notes;2013, Vol. 6 Issue 1, p1 

    Background Metastatic melanoma involving the esophagus is rare; the occurrence of metastatic melanoma in a background of Barrett esophagus is rarer still. We report a case of an 80 year-old male who presented to our institution for workup of Barrett esophagus with high-grade dysplasia and who...

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