Systematic review with meta-analysis: neoplasia detection rate and post-endoscopy Barrett's neoplasia in Barrett's oesophagus.

Autor: Hamade N; Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, USA., Kamboj AK; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA., Krishnamoorthi R; Division of Gastroenterology and Hepatology, Virginia Mason Medical Centre, Seattle, WA, USA., Singh S; Division of Gastroenterology and Hepatology, University of California San Diego, San Diego, CA, USA., Hassett LC; Mayo Clinic, Rochester, MN, USA., Katzka DA; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA., Kahi CJ; Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, USA., Fatima H; Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, USA., Iyer PG; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Jazyk: angličtina
Zdroj: Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2021 Sep; Vol. 54 (5), pp. 546-559. Date of Electronic Publication: 2021 Jul 18.
DOI: 10.1111/apt.16531
Abstrakt: Background: Neoplasia detection rate, the proportion of Barrett's oesophagus patients with high-grade dysplasia or oesophageal adenocarcinoma detected at index surveillance endoscopy has been proposed as a quality metric. However, the correlation between neoplasia detection rate and a clinically relevant outcome like post-endoscopy Barrett's neoplasia remains unknown. Post-endoscopy Barrett's neoplasia refers to the rate of high-grade dysplasia or oesophageal adenocarcinoma on repeat endoscopy within one year of an index screening examination revealing non-dysplastic Barrett's oesophagus or low-grade dysplasia.
Aim: To assess correlation between neoplasia detection rate and post-endoscopy Barrett's neoplasia.
Methods: We performed a systematic search of multiple databases from date of inception to June 2021 to identify cohort studies reporting both neoplasia detection rate and post-endoscopy Barrett's neoplasia. Data from each study were pooled using a random effects model, and their correlation assessed using meta-regression. Heterogeneity was assessed and a priori planned subgroup analyses were conducted.
Results: Ten studies with 27 894 patients with Barrett's oesophagus were included. The pooled neoplasia detection rate and post-endoscopy Barrett's neoplasia were 5.0% (95% CI: 3.4%-7.1%, I 2  = 97%) and 19.6% (95% CI: 10.1%-34.7%, I 2  = 96%), respectively. Meta-regression revealed a statistically significant inverse relationship between the two variables (coefficient -3.50, 95% CI: -4.63 to -2.37, P < 0.01). With every 1% increase of neoplasia detection rate, post-endoscopy Barrett's neoplasia decreased by 3.50%. Heterogeneity was high despite adjusting for study quality and performing several subgroup analyses.
Conclusion: We observed a statistically significant inverse correlation between neoplasia detection rate and post-endoscopy Barrett's neoplasia. Additional studies are needed to further validate this correlation.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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