Sa1531 Endoscopic Surveillance After Complete Eradication of Barrett's Esophagus (BE): Do We Still Need Random Biopsies When There Is No Endoscopic Evidence of Barrett's Epithelium?

Barrett’s epithelium refers to the replacement of the normal stratified squamous epithelium with columnar epithelial cells, possibly as a consequence of chronic reflux of gastric content into the esophagus, and is thought to be a pre-neoplastic disorder with the later development of esophageal adenocarcinoma. In this study, biopsy specimens from patients with Barrett’s esophagus were examined with fluorescein-linked peanut lectin to determine if lectin reactivity, indicative of a previously reported colon cancer-associated mucin in colonic polyps, was present in the columnar lined esophagus. In all of the patients studied, positive but variable labelling with this lectin was present, providing additional evidence that Barrett’s epithelium represents a heterogeneous preneoplastic change of the esophagus.

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Improving cost-effectiveness of endoscopic surveillance for Barrett’s esophagus by reducing low-value care: a review of economic evaluations

Surgical Endoscopy ◽

10.1007/s00464-021-08646-0 ◽

2021 ◽

Author(s):

Ravi Vissapragada ◽

Norma B. Bulamu ◽

Christine Brumfitt ◽

Jonathan Karnon ◽

Roger Yazbeck ◽

...

Keyword(s):

Cost Effectiveness ◽

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Endoscopic Surveillance ◽

Economic Evaluations

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Optical Detection and Eradication of Dysplastic Barrett's Esophagus

Technology in Cancer Research & Treatment ◽

10.1177/153303460300200403 ◽

2003 ◽

Vol 2 (4) ◽

pp. 289-302 ◽

Cited By ~ 7

Author(s):

Louis-Michel Wong Kee Song ◽

Kenneth K. Wang

Keyword(s):

Barrett’S Esophagus ◽

Barrett's Esophagus ◽

Sampling Error ◽

Imaging Techniques ◽

Standard Of Care ◽

Diagnostic Techniques ◽

Endoscopic Surveillance ◽

Current Status ◽

Delay In Diagnosis ◽

Multiple Biopsies

Dysplastic Barrett's esophagus is a condition that offers multiple diagnostic and therapeutic challenges. The diagnosis of dysplasia within Barrett's esophagus currently relies on periodic endoscopic surveillance with multiple biopsies, a methodology limited by random sampling error, inconsistent histopathologic interpretation and delay in diagnosis. Optical spectroscopic and imaging techniques have the potential to identify dysplastic or early neoplastic lesions in real-time. These diagnostic modalities are needed to enhance the endoscopic surveillance of Barrett's esophagus in the future as well as help to define lesions for endoscopic therapy. Esophagectomy has been the standard of care for Barrett's esophagus with high-grade dysplasia although it is a procedure associated with significant morbidity and mortality. Minimally invasive endoscopic ablative therapies are attractive and less morbid alternatives to esophagectomy, with promising results obtained from the use of light-activated drugs (i.e., photodynamic therapy). The combination of novel optical diagnostic techniques and therapies will provide the endoscopist with much needed tools that can considerably enhance the management of patients with Barrett's esophagus. This article reviews the current status and future prospects of optical-based modalities for diagnosis and therapy of dysplastic Barrett's esophagus.

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