Incremental yield of dysplasia detection in Barrett's esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol
| Autor: | Arvind J. Trindade, Jeffrey Novak, Mary Cheung, Keith Sultan, Sumant Inamdar, Molly Stewart, Bethany DeVito, Anil K. Vegesna, Larry S. Miller, Maurice A. Cerulli, Divyesh V. Sejpal, Mohammad Alshelleh, Matthew McKinley, Ronald E. Greenberg |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Databases Factual Esophageal Neoplasms Biopsy Random biopsy Adenocarcinoma 03 medical and health sciences Barrett Esophagus 0302 clinical medicine Endomicroscopy Medicine Humans Radiology Nuclear Medicine and imaging Endoscopy Digestive System Esophagus Aged Retrospective Studies Microscopy Confocal business.industry Gastroenterology Retrospective cohort study Odds ratio medicine.disease Confidence interval medicine.anatomical_structure Dysplasia 030220 oncology & carcinogenesis Barrett's esophagus 030211 gastroenterology & hepatology Female business Nuclear medicine Precancerous Conditions Tomography Optical Coherence |
| Zdroj: | Gastrointestinal endoscopy. 88(1) |
| ISSN: | 1097-6779 |
| Popis: | Background and Aims Volumetric laser endomicroscopy (VLE) is a new wide-field advanced imaging technology for Barrett's esophagus (BE). No data exist on incremental yield of dysplasia detection. Our aim is to report the incremental yield of dysplasia detection in BE using VLE. Methods This is a retrospective study from a prospectively maintained database from 2011 to 2017 comparing the dysplasia yield of 4 different surveillance strategies in an academic BE tertiary care referral center. The groups were (1) random biopsies (RB), (2) Seattle protocol random biopsies (SP), (3) VLE without laser marking (VLE), and (4) VLE with laser marking (VLEL). Results A total of 448 consecutive patients (79 RB, 95 SP, 168 VLE, and 106 VLEL) met the inclusion criteria. After adjusting for visible lesions, the total dysplasia yield was 5.7%, 19.6%, 24.8%, and 33.7%, respectively. When compared with just the SP group, the VLEL group had statistically higher rates of overall dysplasia yield (19.6% vs 33.7%, P = .03; odds ratio, 2.1, P = .03). Both the VLEL and VLE groups had statistically significant differences in neoplasia (high-grade dysplasia and intramucosal cancer) detection compared with the SP group (14% vs 1%, P = .001 and 11% vs 1%, P = .003). Conclusion A surveillance strategy involving VLEL led to a statistically significant higher yield of dysplasia and neoplasia detection compared with a standard random biopsy protocol. These results support the use of VLEL for surveillance in BE in academic centers. |
| Databáze: | OpenAIRE |
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