Dysplasia in short-segment Barrett's esophagus: a prospective 3-year follow-up - PubMed (original) (raw)
. 1997 Nov;92(11):2012-6.
Affiliations
- PMID: 9362182
Dysplasia in short-segment Barrett's esophagus: a prospective 3-year follow-up
P Sharma et al. Am J Gastroenterol. 1997 Nov.
Abstract
Objective: Short segments of intestinal metaplasia in the distal esophagus are being recognized with increasing frequency. Both long and short segments of Barrett's esophagus can progress to dysplasia and cancer. However, the risk of short-segment Barrett's esophagus (SSBE) for the development of dysplasia and adenocarcinoma of the esophagus is not yet known. Our purpose, therefore, was to determine the frequency with which dysplasia occurs in patients with SSBE.
Methods: Patients with SSBE were followed prospectively for the development of dysplasia. SSBE was defined as <3 cm of Barrett's-appearing epithelium above the gastroesophageal junction at endoscopy, with intestinal metaplasia on biopsy as documented by alcian blue stain at pH 2.5 on at least two endoscopic biopsies 6 months apart. Patients had interval upper endoscopy with systematic biopsy of the Barrett's segment.
Results: Fifty-nine SSBE patients were identified. The mean length of Barrett's mucosa was 1.5 +/- 0.1 cm; the mean age of the patients was 63.1 +/- 1.3 yr. Five patients had low-grade dysplasia (LGD) at initial endoscopy, for a prevalence of 8.5%; none had high grade dysplasia (HGD). Thirty-two patients had follow-up endoscopy over a mean period of 36.9 +/- 5.4 months. Five of these patients developed dysplasia on follow-up, three with LGD and two with HGD, the incidence of any dysplasia being 5.7% per year. One patient with HGD that developed during surveillance progressed to adenocarcinoma of the esophagus over a 2-yr period. The other patient with HGD had LGD on follow-up endoscopy. Six patients with initial LGD had no evidence of dysplasia on follow-up.
Conclusions: The prevalence of dysplasia was 8.5% with an incidence of 5.7% per year in this group of SSBE patients, followed prospectively. Although dysplastic changes may not be identified on follow-up examination, some patients progress to adenocarcinoma. Therefore, we recommend surveillance endoscopy and biopsy in patients with SSBE just as in those with long-segment Barrett's esophagus.
Comment in
- Re: Sharma et al. Dysplasia and cancer risk of short-segment Barrett's esophagus.
Romero Y, Riddell RH. Romero Y, et al. Am J Gastroenterol. 1998 Dec;93(12):2639-41. doi: 10.1111/j.1572-0241.1998.02639.x. Am J Gastroenterol. 1998. PMID: 9860463 No abstract available.
Similar articles
- Short segment Barrett's esophagus: relationship of age with extent of intestinal metaplasia.
Benipal P, Garewal HS, Sampliner RE, Martinez P, Hayden CW, Fass R. Benipal P, et al. Am J Gastroenterol. 2001 Nov;96(11):3084-8. doi: 10.1111/j.1572-0241.2001.05262.x. Am J Gastroenterol. 2001. PMID: 11721753 - Dysplasia and cancer in a large multicenter cohort of patients with Barrett's esophagus.
Sharma P, Falk GW, Weston AP, Reker D, Johnston M, Sampliner RE. Sharma P, et al. Clin Gastroenterol Hepatol. 2006 May;4(5):566-72. doi: 10.1016/j.cgh.2006.03.001. Epub 2006 Apr 17. Clin Gastroenterol Hepatol. 2006. PMID: 16630761 - [Surveillance of patients with Barrett's esophagus].
Endlicher E, Knüchel R, Messmann H. Endlicher E, et al. Z Gastroenterol. 2001 Aug;39(8):593-600. doi: 10.1055/s-2001-16695. Z Gastroenterol. 2001. PMID: 11558064 Review. German. - [Barrett's esophagus. Prevalence, risk of adenocarcinoma, role of endoscopic surveillance].
Zaninotto G, Costantini M, Molena D, Rizzetto C, Ekser B, Ancona E. Zaninotto G, et al. Minerva Chir. 2002 Dec;57(6):819-36. Minerva Chir. 2002. PMID: 12592224 Review. Italian.
Cited by
- Endoscopic ablation is a cost-effective cancer preventative therapy in patients with Barrett's esophagus who have elevated genomic instability.
Das A, Callenberg KM, Styn MA, Jackson SA. Das A, et al. Endosc Int Open. 2016 May;4(5):E549-59. doi: 10.1055/s-0042-103415. Epub 2016 Apr 15. Endosc Int Open. 2016. PMID: 27227114 Free PMC article. - Barrett's esophagus.
Peters JH, Hagen JA, DeMeester SR. Peters JH, et al. J Gastrointest Surg. 2004 Jan;8(1):1-17. doi: 10.1016/s1091-255x(03)00136-7. J Gastrointest Surg. 2004. PMID: 14746830 Review. No abstract available. - Surveillance in Patients With Barrett's Esophagus for Early Detection of Esophageal Adenocarcinoma: A Systematic Review and Meta-Analysis.
Qiao Y, Hyder A, Bae SJ, Zarin W, O'Neill TJ, Marcon NE, Stein L, Thein HH. Qiao Y, et al. Clin Transl Gastroenterol. 2015 Dec 10;6(12):e131. doi: 10.1038/ctg.2015.58. Clin Transl Gastroenterol. 2015. PMID: 26658838 Free PMC article. - Differences in the Characteristics of Barrett's Esophagus and Barrett's Adenocarcinoma between the United States and Japan.
Oryu M, Mori H, Kobara H, Nishiyama N, Fujihara S, Kobayashi M, Yasuda M, Masaki T. Oryu M, et al. ISRN Gastroenterol. 2013 Mar 28;2013:840690. doi: 10.1155/2013/840690. Print 2013. ISRN Gastroenterol. 2013. PMID: 23606979 Free PMC article. - Surveillance in Barrett's oesophagus: a personal view.
Basu KK, de Caestecker JS. Basu KK, et al. Postgrad Med J. 2002 May;78(919):263-8. doi: 10.1136/pmj.78.919.263. Postgrad Med J. 2002. PMID: 12151566 Free PMC article. Review.