[Detection of early neoplasia in Barrett's oesophagus: focus attention on index endoscopy in short-segment-Barrett's oesophagus with random biopsies]. / Detektion von frühen Neoplasien im Barrett-Ösophagus: Ein Plädoyer für die Wertigkeit der Indexendoskopie und 4-Quadranten-Biopsien im Short-Segment-Barrett-Ösophagus.
Z Gastroenterol
; 53(6): 568-72, 2015 Jun.
Article
em De
| MEDLINE
| ID: mdl-26075367
ABSTRACT
BACKGROUND:
Detecting early neoplasias in Barrett's oesophagus (BE) is challenging. Recent publications have been focusing on improving the detection of such lesions during Barrett's surveillance. However in a recently published Danish register study calculating the risk for cancer-development in BE two-thirds of the diagnosed tumors were identified during the first examination or in the first year. This means that index endoscopy might be more effective than surveillance in detecting early neoplasia in BE.METHODS:
In the period from January 2010 to April 2011, all patients who consecutively presented with a diagnosis of early neoplastic changes in BE were recorded prospectively.ANALYSIS:
The analysis included data for 121 patients. In patients with short-segment BE (SSBE), neoplasia was only diagnosed in 6â% of cases in the surveillance examination, compared with 44â% of cases in long-segment BE (LSBE). The neoplastic lesion was identified visually in 43 patients (36â%) during the external EGD. Type II tumours were detected in 40â% (39/98) and were correctly assessed as neoplastic in 25â% of cases (24/98).CONCLUSIONS:
1. in patients with SSBE almost all early tumours are diagnosed by index endoscopy and not by Barrett's surveillance; 2. around 40â% of all early neoplasias are endoscopically invisible and are only diagnosed using four-quadrant biopsies; 3. the macroscopic tumour type has a substantial influence on the detection rate for neoplasia. If efforts to increase the detection rate for early neoplasia in BE are focused solely on the Barrett's surveillance method, then only a minority of patients - 20â% in the present group - will benefit from the measure. German clinical trials register, DRKS00â004â168.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Pré-Cancerosas
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Esôfago de Barrett
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Neoplasias Esofágicas
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Esofagoscopia
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Esôfago
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Detecção Precoce de Câncer
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Prognostic_studies
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Screening_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
De
Revista:
Z Gastroenterol
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Alemanha