Endoscopic features of low-grade dysplastic Barrett's.

Autor:	He T; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia.; Faculty of Medicine, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Australia., Iyer KG; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia., Lai M; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia., House E; Pathology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia., Slavin JL; Pathology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia., Holt B; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia.; Faculty of Medicine, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Australia., Tsoi EH; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia.; Faculty of Medicine, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Australia., Desmond P; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia.; Faculty of Medicine, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Australia., Taylor ACF; Gastroenterology, St Vincent's Hospital Melbourne Pty Ltd, Fitzroy, Australia.; Faculty of Medicine, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Australia.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2023 Aug 07; Vol. 11 (8), pp. E736-E742. Date of Electronic Publication: 2023 Aug 07 (Print Publication: 2023).
DOI:	10.1055/a-2102-7726
Abstrakt:	Background and study aims Barrett's esophagus (BE) with low-grade dysplasia (LGD) is considered usually endoscopically invisible and the endoscopic features are not well described. This study aimed to: 1) evaluate the frequency of visible BE-LGD; 2) compare rates of BE-LGD detection in the community versus a Barrett's referral unit (BRU); and 3) evaluate the endoscopic features of BE-LGD. Patients and methods This was a retrospective analysis of a prospectively observed cohort of 497 patients referred to a BRU with dysplastic BE between 2008 and 2022. BE-LGD was defined as confirmation of LGD by expert gastrointestinal pathologist(s). Endoscopy reports, images and histology reports were reviewed to evaluate the frequency of endoscopically identifiable BE-LGD and their endoscopic features. Results A total of 135 patients (27.2%) had confirmed BE-LGD, of whom 15 (11.1%) had visible LGD identified in the community. After BRU assessment, visible LGD was detected in 68 patients (50.4%). Three phenotypes were observed: (A) Non-visible LGD; (B) Elevated (Paris 0-IIa) lesions; and (C) Flat (Paris 0-IIb) lesions with abnormal mucosal and/or vascular patterns with clear demarcation from regular flat BE. The majority (64.7%) of visible LGD was flat lesions with abnormal mucosal and vascular patterns. Endoscopic detection of BE-LGD increased over time (38.7% (2009-2012) vs. 54.3% (2018-2022)). Conclusions In this cohort, 50.4% of true BE-LGD was endoscopically visible, with increased recognition endoscopically over time and a higher rate of visible LGD detected at a BRU when compared with the community. BRU assessment of BE-LGD remains crucial; however, improving endoscopy surveillance quality in the community is equally important. Competing Interests: Conflict of Interest The authors declare that they have no conflict of interest. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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