African Americans with Barrett’s Esophagus Are Less Likely to Have Dysplasia at Biopsy
25
Citation
26
Reference
10
Related Paper
Citation Trend
Keywords:
Barrett's esophagus
Intestinal metaplasia
Hiatal Hernia
Intestinal metaplasia
Barrett's esophagus
Metaplasia
Cite
Citations (108)
Intestinal metaplasia
Barrett's esophagus
Cumulative incidence
Cite
Citations (98)
BACKGROUND
Biopsy specimens obtained from the gastro-oesophageal junction can reveal intestinal metaplasia in patients presenting for routine upper endoscopy. The site of biopsy may play a critical role in determining the dysplasia risk of a patient.AIMS
To evaluate prospectively the dysplasia risk in patients with intestinal metaplasia of the distal oesophagus or within the gastric cardia.METHODS
Patients with short segment Barrett9s oesophagus (SSBO) and cardia intestinal metaplasia (CIM) were followed prospectively.RESULTS
177 patients with SSBO were identified (mean age 62 years, range 38–82; 91% whites). Twenty prevalence cases of dysplasia in SSBO were detected: 17 low grade dysplasia (LGD), three high grade dysplasia (HGD). Seventy six patients with CIM were identified (mean age 67 years, range 37–81; 81% whites). A single prevalence case of LGD in CIM was detected. During follow up of 78 SSBO and 34 CIM patients, dysplasia developed in nine (seven LGD, two HGD) with SSBO and in one (LGD) with CIM. There were significant differences between the two groups with respect to age, ethnicity, dysplasia prevalence, and incidence. Time to dysplasia progression was significantly longer in CIM compared with SSBO patients. Of the five patients with SSBO and HGD, one developed adenocarcinoma of the oesophagus on follow up. No HGD or cancers have been detected over this time period in CIM patients.CONCLUSIONS
The dysplasia risk is significantly greater in SSBO than in CIM patients, indicating two potentially different clinical processes. Future studies should separate SSBO from CIM in order to enhance the understanding of the pathophysiology and malignant potential of each entity.Intestinal metaplasia
Esophageal disease
Metaplasia
Barrett's oesophagus
GASTRIC CARDIA
Cite
Citations (188)
See also: Commentaire de travail de M. Kerkhof et al., pp. 772Endoscopy 2007; 39(09): 930-930DOI: 10.1055/s-0032-1308865
Intestinal metaplasia
Barrett's esophagus
Metaplasia
Cite
Citations (12)
Objective:To explore the clinical epidemiologic characteristics and tendency of gastric epithelial dysplasia and intestinal metaplasia in Western Yu region.Methods:The clinical data of 21932 patients by gastroscopy were collected from 2007 to 2010,the clinical and pathology data of gastric epithelial dysplasia and intestinal metaplasia were analyzed retrospectively.Results:Age,at which dysplasia and dysplasia accompanied with intestinal metaplasia could be deteced,showed an increasing trend.The degree of dysplasia was related to age.The percentage of patients who were above 60 years of age in severe dysplasia was much higer than that in mild and moderate dysplasia(P0.05),and in moderate dysplasia was much higher than mild dysplasia(P0.05).The proportion of patients who were above 60 years of age was significantly greater in moderate intestinal metaplasia compared with that in mild intestinal metaplasia.The proporation of patients who were above 60 years of age was significantly higher in the gastric cardia than that in gastric corpus and gastric incisura.The detection of Hp in gastric epithelial dysplasia and intestinal metaplasia was higher than in chronic superficial gastritis.Conclusion:Gastric epithelial dysplasia and intestinal metaplasia was related with age and Helicobacter pylori and it mostly located on the gastric cardia.
Intestinal metaplasia
Metaplasia
Cite
Citations (0)
Intestinal metaplasia
Barrett's esophagus
Metaplasia
Cite
Citations (8)
Barrett's esophagus has been associated with the presence of hiatal hernia; however, to date no meta-analysis of the relationship has been performed. We aimed to conduct a systematic review and meta-analysis, providing a quantitative estimate of the increased risk of Barrett's esophagus associated with hiatal hernia.A search was conducted through four electronic databases (Medline, PubMed, Embase, and Current Contents Connect) to 4 April 2012, for observational studies of Barrett's esophagus patients. We calculated pooled odds ratios and 95% confidence intervals using a random effects model for the association of hiatal hernia with any length Barrett's esophagus, as well as with short segment Barrett's esophagus and long segment Barrett's esophagus. 33 studies comprising 4390 Barrett's esophagus patients were eligible for the meta-analysis.Hiatal hernia was associated with an increased risk of Barrett's esophagus of any length (odds ratio 3.94; 95% confidence interval 3.02-5.13). Heterogeneity was present (I2 = 82.03%, P < 0.001), and the Egger test for publication bias was significant (P = 0.0005). The short segment Barrett's esophagus subgroup analysis likewise showed an increased risk (odds ratio 2.87; 95% confidence interval 1.75-4.70). The strongest association was between hiatal hernia and long segment Barrett's esophagus (odds ratio 12.67; 95% confidence interval 8.33-19.25). The increased risk was present even after adjusting for reflux and body mass index. The presence of hiatal hernia was associated with an increased risk of Barrett's esophagus, even after adjusting for clinically significant confounders. The strongest association was found between hiatal hernia and long segment Barrett's esophagus.
Hiatal Hernia
Barrett's esophagus
Cite
Citations (71)
Barrett's esophagus
Intestinal metaplasia
Metaplasia
Cite
Citations (37)
SUMMARY Quality indicators have been proposed for endoscopic eradication therapy of Barrett's esophagus (BE). One such measure suggests that complete eradication of intestinal metaplasia (CE-IM) should be achieved within 18 months of starting treatment. The aim of this study was to assess whether achievement of CE-IM within 18 months is associated with improved long-term clinical outcomes. This was a retrospective cohort study of BE patients who underwent endoscopic eradication. Time to CE-IM was recorded and categorized as ≤ or > 18 months. The main outcome measures were recurrence of IM and of dysplasia after CE-IM, defined as a single endoscopy without endoscopic evidence of BE or histologic evidence of intestinal metaplasia. Recurrence was analyzed using the Kaplan–Meier method and multivariable Cox proportional hazards modeling. A total of 290 patients were included in the analyses. The baseline histology was high-grade dysplasia or intramucosal carcinoma in 74.2% of patients. CE-IM was achieved in 85.5% of patients, and 54.1% of the cohort achieved CE-IM within 18 months. Achieving CE-IM within 18 months was not associated with reduced risk of recurrence of IM or dysplasia in both unadjusted and adjusted analyses. In this cohort, older age and increased BE length were associated with IM recurrence, and increased hiatal hernia size was associated with dysplasia recurrence. Compared to longer times, achieving CE-IM within 18 months was not associated with a reduced risk of recurrence of IM or dysplasia. Alternative evidence-based quality metrics for endoscopic eradication therapy should be identified.
Intestinal metaplasia
Barrett's esophagus
Hiatal Hernia
Endoscopic mucosal resection
Cite
Citations (3)
IM To study the relationship between intestinal metaplasia or dysplasia of gastric mucosa and gastric cancer. METHODS P21 and P53 protein expressions were determined in 58 formalinfixed, paraffinembedded specimens of intestinal metaplasia (n=44) and dysplasia of gastric mucosa (n=14) by the SP immunohistochemical method. RESULTS The positive rates of P21 and P53 proteins in type Ⅱb intestinal metaplasia (IM) (700% and 300%) were statistically higher than those in type Ⅰb IM (258% and 64%,P001). The positive rates of P21 and P53 proteins in dysplasia (428% and 285%) were higher than those in IM (34% and 118%). The positive rates of P21 and P53 proteins in dysplasia with type Ⅱb IM (625% and 375%) were significantly higher than those in dysplasia with type Ⅰb IM (166% and 166%).CONCLUSION Dysplasia accompanied by type Ⅱb IM may more easily develop gastric cancer than other lesions.
Intestinal metaplasia
Metaplasia
Cite
Citations (3)