Post-endoscopy Barrett's neoplasia after a negative index endoscopy: a systematic review and proposal for definitions and performance measures in endoscopy.

Autor:	Desai M; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.; Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA., Lieberman D; Department of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon, USA., Srinivasan S; Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA., Nutalapati V; Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA., Challa A; Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA., Kalgotra P; Raymond J. Harbert College of Business, Auburn University, Auburn, Alabama, USA., Sundaram S; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.; Department of Medicine, St. Peter's University Hospital, New Brunswick, New Jersey, USA., Repici A; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Hassan C; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy., Kaminski MF; Department of Gastroenterological Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, and Department of Gastroenterology, Hepatology and Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland.; Institute of Health and Society, University of Oslo, Oslo, Norway., Sharma P; Department of Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA.; Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA.
Jazyk:	angličtina
Zdroj:	Endoscopy [Endoscopy] 2022 Sep; Vol. 54 (9), pp. 881-889. Date of Electronic Publication: 2022 Jan 03.
DOI:	10.1055/a-1729-8066
Abstrakt:	Background: A high rate of neoplasia, both high grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) has been reported in Barrett's esophagus at index endoscopy, but precise rates of post-endoscopy Barrett's neoplasia (PEBN) are unknown. Methods: A systematic review and meta-analysis was performed examining electronic databases (inception to October 2021) for studies reporting PEBN. Consistent with the definitions of post-colonoscopy colorectal cancer proposed by the World Endoscopy Organization, we defined neoplasia (HGD/EAC) detected at index endoscopy and/or within 6 months of a negative index endoscopy as "prevalent" neoplasia, that detected after 6 months of a negative index endoscopy and prior to next surveillance interval (i. e. 3 years) as PEBN or "interval" neoplasia, and that detected after 36 months from a negative index endoscopy as "incident" neoplasia. The pooled incidence rates and proportions relative to total neoplasia were analyzed. Results: 11 studies (n = 59 795; 61 % men; mean [SD] age 62.3 [3.3] years) met the inclusion criteria. The pooled incidence rates were: prevalent neoplasia 4.5 % (95 %CI 2.2 %-8.9 %) at baseline and an additional 0.3 % (0.1 %-0.7 %) within the first 6 months, PEBN 0.52 % (0.46 %-0.58 %), and incident neoplasia 1.4 % (0.9 %-2.1 %). At 3 years from the index endoscopy, PEBN accounted for 3 % of total Barrett's neoplasia, while prevalent neoplasia accounted for 97 %. Conclusion: Neoplasia detected at or within 6 months of index endoscopy accounts for most cases of Barrett's neoplasia (> 90 %). PEBN accounts for ~3 % of cases and can be used for validation in future. This highlights the importance of a high quality index endoscopy in Barrett's esophagus and the need to establish quality benchmarks to measure endoscopists' performance. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu