Alimentary TractExtent of high-grade dysplasia in Barrett's esophagus correlates with risk of adenocarcinoma*,**
Section snippets
Study design
Patients with Barrett's esophagus and HGD who were followed up with a uniform surveillance program as part of the Mayo Clinic Barrett's Esophagus project were assessed in this retrospective cohort study. Patients were classified into focal or diffuse HGD based on the extent of HGD on endoscopic biopsy specimens for Barrett's esophagus. In a prospective fashion, follow-up information was collected to determine their cancer-free survival rate from the date of first endoscopic biopsy at the Mayo
Results
During the study period, 134 patients were diagnosed with Barrett's esophagus and HGD on endoscopic biopsy. Thirty-four patients were excluded from the analysis (Figure 2) for the following reasons: 8 patients had a mass lesion on endoscopy and the biopsy specimen was suspicious for adenocarcinoma, and 4 patients had no obvious mass lesion but there was suspicion for adenocarcinoma. These 12 patients were only excluded after confirmation of adenocarcinoma by the study pathologist. Ten patients
Discussion
Barrett's esophagus is a premalignant condition in which the normal squamous epithelium of the lower esophagus is replaced by specialized columnar intestinal epithelium.1, 3, 4 The association of a columnar-lined esophagus with adenocarcinoma was first described by Adler in the early 1950s.20 Morson later noted that dysplasia could be shown on biopsy, which may identify patients who are likely to have or develop cancer.21 Studies subsequently have showed that HGD in Barrett's esophagus was
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Barrett's Esophagus and Associated Dysplasia
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2023, Techniques and Innovations in Gastrointestinal EndoscopyMedical and Surgical Therapy for Gastroesophageal Reflux Disease and Barrett Esophagus
2019, Shackelford's Surgery of the Alimentary Tract: 2 Volume SetAblation for Patients With Barrett or Dysplasia
2019, Shackelford's Surgery of the Alimentary Tract: 2 Volume SetBarrett's Esophagus: Diagnosis, Surveillance, and Medical Management
2019, Clinical Gastrointestinal EndoscopyBarrett's esophagus: A comprehensive review for the internist
2018, Disease-a-Month
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Address requests for reprints to: Kenneth K. Wang, M.D., Main Alfred Gastroenterology Unit, St. Mary's Hospital, 1216 Second Street S.W., Rochester, Minnesota 55905. e-mail: [email protected].
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Supported by grants CA85992-01 and CA78870-01 from the National Institutes of Health and by the Mayo Foundation.