Consistency of a high-grade dysplasia diagnosis in Barrett's oesophagus: A Dutch nationwide cohort study
| Autor: | Jantine W. P. M. van Baal, Martijn G.H. van Oijen, Romy E. Verbeek, Fiebo J.W. ten Kate, Frank P. Vleggaar, Peter D. Siersema |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Risk medicine.medical_specialty Multivariate analysis Esophageal Neoplasms Biopsy Adenocarcinoma Gastroenterology Cohort Studies Barrett Esophagus Internal medicine Humans Medicine Aged Netherlands Proportional Hazards Models Retrospective Studies Hepatology business.industry Endoscopy Retrospective cohort study Middle Aged University hospital medicine.disease Dysplasia Cohort Barrett's oesophagus Disease Progression Female Histopathology Radiology Neoplasm Grading business Cohort study |
| Zdroj: | Digestive and Liver Disease. 46:318-322 |
| ISSN: | 1590-8658 |
| DOI: | 10.1016/j.dld.2013.11.010 |
| Popis: | Background Consistency of high-grade dysplasia in Barrett's oesophagus is incompletely known and the clinical course may vary between patients. Aims To evaluate the consistency of high-grade dysplasia diagnosis in a Dutch nationwide cohort and to identify predictors for (re-)detecting high-grade dysplasia or oesophageal adenocarcinoma when ≥1 follow-up evaluations after an initial high-grade dysplasia diagnosis were scored with a lower histological grade. Methods In this retrospective cohort study, all patients diagnosed with high-grade dysplasia in Barrett's oesophagus between 1999 and 2008 in the Netherlands were selected using the nationwide histopathology registry. Multivariate analysis was performed to identify predictors for (re-)detecting high-grade dysplasia or oesophageal adenocarcinoma in patients with ≥1 follow-up evaluations scored with a lower grade. Results In total, 512 high-grade dysplasia patients were included, of whom 53% had ≥1 follow-up evaluations scored with a lower grade. The (re-)detection risk was increased when follow-up was performed in a university hospital and when endoscopic/surgical resection was performed and decreased with an increasing number of follow-up evaluations scored with a lower grade. Conclusion High-grade dysplasia diagnosis was inconsistent in more than half of patients. (Endoscopic) resection in an expert centre is recommended to (re-)detect high-grade dysplasia or oesophageal adenocarcinoma when an endoscopic follow-up protocol with biopsies repeatedly shows a lower histological grade. |
| Databáze: | OpenAIRE |
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