Directional distribution of neoplasia in Barrett's esophagus is not influenced by distance from the gastroesophageal junction.
Gastrointest Endosc
; 77(6): 877-82, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23528657
ABSTRACT
BACKGROUND:
Accurate endoscopic detection and staging are critical for appropriate management of Barrett's esophagus (BE)-associated neoplasia. Prior investigation has demonstrated that the distribution of endoscopically detectable early neoplasia is not uniform but instead favors specific directional distributions within a short BE segment; however, it is unknown whether the directional distribution of neoplasia differs with increasing distance from the gastroesophageal junction, including in patients with long-segment BE.OBJECTIVE:
To identify whether directional distribution of BE-associated neoplasia is influenced by distance from the gastroesophageal junction.DESIGN:
Retrospective cohort study.SETTING:
Tertiary-care referral center. PATIENTS Patients with either short-segment or long-segment BE undergoing EMR. INTERVENTION EMR. MAIN OUTCOME MEASUREMENTS Directional distribution of BE-associated neoplasia stratified by distance from gastroesophageal junction.RESULTS:
EMR was performed on 60 lesions meeting study criteria during the specified time period. Pathology demonstrated low-grade dysplasia in 22% (13/60), high-grade dysplasia in 38% (23/60), intramucosal (T1a) adenocarcinoma in 23% (14/60), and invasive (≥ T1b) adenocarcinoma in 17% (10/60). Directional distribution of lesions was not uniform (P < .001), with 62% of lesions (37/60) located between the 1 o'clock and 5 o'clock positions. When circular statistics methodology was used, there was no difference in the directional distribution of neoplastic lesions located within 3 cm of the gastroesophageal junction compared with ≥ 3 cm from the gastroesophageal junction.LIMITATIONS:
Single-center study may limit external validity.CONCLUSION:
The directional distribution of neoplastic foci within a BE segment is not influenced by distance of the lesion from the gastroesophageal junction. Mucosa between the 1 o'clock and 5 o'clock locations merits careful attention and endoscopic inspection in individuals with both short-segment BE and long-segment BE.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
/
Neoplasias Esofágicas
/
Carcinoma in Situ
/
Adenocarcinoma
/
Junção Esofagogástrica
/
Mucosa
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos