Barrett's esophagus and gland cancer - the experience of one center

2018 ◽  
Vol 90 (3) ◽  
pp. 19-24 ◽  
Author(s):  
Zbigniew Kula ◽  
Andrzej Nowicki ◽  
Alicja Świerszczyńska
Keyword(s):  
Esophageal Cancer ◽  
Intestinal Metaplasia ◽  
Barrett’S Esophagus ◽  
Retrospective Review ◽  
Medical Records ◽  
Barrett's Esophagus ◽  
Clinical Aspects ◽  
Men And Women ◽  
Upper Gastrointestinal

Objective: The aim of the study was to evaluate the prevalence and clinical aspects of Barrett's esophagus and adenocarcinoma of the lower part of esophagus in gastroscopy. Material and methods: Retrospective review of 10000 upper gastrointestinal endoscopic examinations were performed at the Department of Oncology Endoscopy in Bydgoszcz from 2004 to 2014 in terms of incidence of Barrett's esophagus and adenocarcinoma in the lower part of esophagus. Results: The medical records of 5378 (53.8%) women and 4622 (46.2%) men were analyzed. The average age of men and women was 62.4 and 62.7, respectively. Barrett's esophagus was diagnosed in 67 patients, including 38 (56.7%) of men where the average age of men and women was 56.9 and 60.2 years, respectively. The most commonly reported symptom was heartburn occurred in 45 (67.2%) of patients. During ten years of follow-up PB examination the adenocarcinomas were detected in 3 (4.47%) cases. Adenocarcinoma was diagnosed in 46 patients, of whom 37 in men. In the case of 27 patients (58.7%), esophageal cancer was treated with the intention of radicalization. The probability of 5-year survival in these patients was 10.2% for women and 9.2% for men. Conclusions: The number of Barrett's esophagus and adenocarcinoma are increasing at 0.67% and 0.46% annually, respectively. The risk of adenocarcinoma developed from Barrett's esophagus during endoscopic follow-up period was 4.47%. Barrett's esophagus is more common in men before the age of 60, and nearly half of them have intestinal metaplasia without dysplasia. Probability of 5-year survival in patients with adenocarcinoma was 9.7%.

scholarly journals Barrett’s Esophagus and Cardiac Intestinal Metaplasia: Two Conditions within the Same Spectrum

2008 ◽  
Vol 22 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Nicole White ◽  
Manal Gabril ◽  
Gershon Ejeckam ◽  
Maria Mathews ◽  
John Fardy ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Barrett’S Esophagus ◽  
Sensitivity And Specificity ◽  
Barrett's Esophagus ◽  
Periodic Acid ◽  
Clinical History ◽  
Acid Reflux ◽  
Cytokeratin 20 ◽  
Periodic Acid Schiff

BACKGROUND: Immunostaining for cytokeratin 7 (CK7) and cytokeratin 20 (CK20) has a characteristic pattern in Barrett’s esophagus (BE), but reports regarding its sensitivity and specificity are inconsistent. Intestinal metaplasia of the gastric cardia (CIM) is histologically similar to BE, but with no abnormal endoscopic findings.OBJECTIVES: To evaluate the sensitivity and specificity of a semi-quantitative CK7/CK20 immunostaining pattern for the diagnosis of BE, and to further elucidate the pathogenesis of CIM.METHODS: Tissues were examined by hematoxylin and eosin and periodic acid schiff/alcian blue stains, and then were immunostained with CK7 and CK20 antibodies. Correlations with other clinical parameters were statistically analyzed.RESULTS: When values were revised based on follow-up data and auxiliary testing, all BE cases (100%) displayed the characteristic BE CK7/CK20 immunostaining pattern, compared with 66% of CIM cases. In the subgroup of patients who were endoscopically and immunohistochemistry-positive but histologically negative, all patients except for one had documented BE when clinical history, auxiliary testing and follow-up were evaluated. There were no statistically significant differences between BE and CIM regardingHelicobacter pyloriinfection or the type of metaplasia (complete versus incomplete). The sensitivity of the CK7/CK20 pattern reached 100% in the subgroup of CIM patients with a history of acid reflux. Of 26 cases of CIM where follow-up was available, four cases (15%) progressed to BE, and one developed dysplasia. All four cases showed the BE pattern of CK7/CK20 staining and were negative forH pyloriinfection.CONCLUSIONS: A semiquantitative CK7/CK20 pattern can be used to confirm BE even in the absence of histological evidence. The subgroup of CIM with acid reflux may develop into BE and may need closer follow-up.

scholarly journals Laparoscopic Surgical Treatment for Patients With Short- and Long-Segment Barrett's Esophagus: Which Technique in Which Patient?

2011 ◽  
Vol 96 (2) ◽  
pp. 95-103 ◽  
Author(s):  
Italo Braghetto ◽  
Owen Korn ◽  
Héctor Valladares ◽  
Aníbal Debandi ◽  
Juan Carlos Díaz ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Erosive Esophagitis ◽  
Laparoscopic Approach ◽  
Acid Suppression ◽  
Antireflux Procedure ◽  
Short Segment ◽  
Duodenal Diversion

Abstract Laparoscopic antireflux surgery is very successful in patients with short-segment Barrett's esophagus (BE), but in patients with long-segment BE, the results remain in discussion. In these patients, during the open era of surgery, we performed acid suppression + duodenal diversion procedures added to the antireflux procedure (fundoplication + vagotomy + antrectomy + Roux-en-Y gastrojejunostomy) to obtain better results at long-term follow-up. The aim of this prospective study is to present the results of 3 to 5 years' follow-up in patients with short-segment and long-segment or complicated BE (ulcer or stricture) who underwent fundoplication or the acid suppression–duodenal diversion technique, both performed by a laparoscopic approach. One hundred eight patients with histologically confirmed BE were included: 58 patients with short-segment BE, and 50 with long-segment BE, 28 of whom had complications associated with severe erosive esophagitis, ulcer, or stricture. After surgery, among patients treated with fundoplication with cardia calibration, endoscopic erosive esophagitis was observed in 6.9% of patients with short-segment BE, while 50% of patients with long-segment BE presented with positive acid reflux, persistence of endoscopic esophagitis with intestinal metaplasia, and progression to dysplasia (in 5% of cases; P  =  0.000). On the contrary, after acid suppression–duodenal diversion surgery in patients with long-segment BE, more than 95.6% presented with successful results regarding recurrent symptoms and endoscopic regression of esophagitis. Regression of intestinal metaplasia to the cardiac mucosa was observed in 56.9% of patients with short-segment BE who underwent fundoplication and in 61% of those with long-segment BE treated with the acid suppression–duodenal diversion procedure. Patients with long-segment BE who experienced fundoplication alone presented no regression of intestinal metaplasia; on the contrary, progression to dysplasia was observed in 1 case (P  =  0.049). Patients with short-segment BE can be successfully treated with fundoplication, but for patients with long-segment BE, we suggest performance of fundoplication plus an acid suppression–duodenal diversion procedure.

P.10.10 SCCA-IGM DETERMINATION IN BARRETT'S ESOPHAGUS AND ESOPHAGEAL CANCER MIGHT REGULATE ENDOSCOPIC FOLLOW-UP SCHEDULE

2012 ◽  
Vol 44 ◽  
pp. S151
Author(s):  
V. Zorzetto ◽  
G. Maddalo ◽  
M. Rugge ◽  
P. Parente ◽  
G. Zaninotto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus

scholarly journals Risk Prediction of Barrett’s Esophagus in a Taiwanese Health Examination Center Based on Regression Models

2021 ◽  
Vol 18 (10) ◽  
pp. 5332
Author(s):  
Po-Hsiang Lin ◽  
Jer-Guang Hsieh ◽  
Hsien-Chung Yu ◽  
Jyh-Horng Jeng ◽  
Chiao-Lin Hsu ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Risk Prediction ◽  
Barrett's Esophagus ◽  
Gastrointestinal Endoscopy ◽  
Prediction Models ◽  
Upper Gastrointestinal Endoscopy ◽  
Health Examination ◽  
Endoscopic Screening ◽  
Risk Prediction Models ◽  
Upper Gastrointestinal

Determining the target population for the screening of Barrett’s esophagus (BE), a precancerous condition of esophageal adenocarcinoma, remains a challenge in Asia. The aim of our study was to develop risk prediction models for BE using logistic regression (LR) and artificial neural network (ANN) methods. Their predictive performances were compared. We retrospectively analyzed 9646 adults aged ≥20 years undergoing upper gastrointestinal endoscopy at a health examinations center in Taiwan. Evaluated by using 10-fold cross-validation, both models exhibited good discriminative power, with comparable area under curve (AUC) for the LR and ANN models (Both AUC were 0.702). Our risk prediction models for BE were developed from individuals with or without clinical indications of upper gastrointestinal endoscopy. The models have the potential to serve as a practical tool for identifying high-risk individuals of BE among the general population for endoscopic screening.

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