Clinical outcomes in patients with a diagnosis of "indefinite for dysplasia" in Barrett's esophagus: a multicenter cohort study.
Endoscopy
; 47(8): 669-74, 2015 Aug.
Article
em En
| MEDLINE
| ID: mdl-25910065
ABSTRACT
BACKGROUND AND STUDY AIM:
Data are limited on the natural history of patients with Barrett's esophagus with a diagnosis of "indefinite for dysplasia" (IND). The aims of this study were to (i) determine rates of progression to high grade dysplasia (HGD) or esophageal adenocarcinoma, and compare these with rates for low grade dysplasia (LGD); and (ii) determine the proportion of patients whose histological IND diagnosis changed on follow-up endoscopy. PATIENTS ANDMETHODS:
Demographic, endoscopic, and histologic information of patients with diagnoses of IND and LGD and at least 12 months of follow-up were extracted from the database of a multicenter Barrett's esophagus study. Rates and times for progression to HGD and esophageal adenocarcinoma and regression to nondysplastic epithelium were calculated. Proportions of diagnoses upgraded to HGD/esophageal adenocarcinoma or downgraded to nondysplastic epithelium at first follow-up endoscopy were evaluated.RESULTS:
Amongst 2264 patients, 83 with a diagnosis of IND (mean age 60 years, 95â% men, 95â% white; mean follow-up 5.6 years) and 79 with diagnosis of LGD were identified. In the IND group, annual incidences of esophageal adenocarcinoma and HGD were 0.21â% and 0.64â%, respectively, representing a combined incidence of 0.8â%. Mean time to progression was 4.72 years. Within the IND group 55â% patients showed regression to nondysplastic epithelium at first follow-up endoscopy and the overall regression rate was 80â%. Corresponding rates in LGD patients were similar.CONCLUSIONS:
Lesions diagnosed as IND and LGD show similar biological behavior and can be treated as a single category with respect to surveillance and follow-up.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Esôfago de Barrett
/
Transtornos de Deglutição
/
Endoscopia Gastrointestinal
/
Esôfago
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos