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 17 November 2017

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News

Risk of adenocarcinoma and high-grade intraepithelial neoplasia in Barrett's esophagus

The incidence of high-grade intraepithelial neoplasia and adenocarcinoma is low in patients with adequately treated Barrett's esophagus, find doctors in the latest issue of Endoscopy.

News image

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Barrett's esophagus is a premalignant condition. The risk of developing high-grade intraepithelial neoplasia or adenocarcinoma is unclear.

In this study, Dr Martinek and colleagues investigated the incidence of high-grade intraepithelial neoplasia and adenocarcinoma in a cohort of patients with Barrett's esophagus.

All patients included in the study had intestinal metaplasia and macroscopic evidence of short- or long-segment Barrett's esophagus.

The patients underwent a standard protocol including regular endoscopy with biopsies. They were also treated using a proton pump inhibitor or antireflux surgery.

Overall, a total of 135 patients underwent 623 endoscopies during 700 patient-years of follow-up.

Annual risk of high-grade intraepithelial neoplasia or adenocarcinoma = 0.21 %.
Endoscopy

The team detected simultaneous high-grade intraepithelial neoplasia and adenocarcinoma in 2 patients with long-segment Barrett's esophagus.

Low-grade intraepithelial neoplasia was detected in 19% patients, but in nearly half of these patients it was not confirmed in later biopsies.

The doctors calculated the incidence of high-grade intraepithelial neoplasia and adenocarcinoma as 1/350 patient-years.

The team found endoscopic regression of Barrett's esophagus in 21 % of patients.

Dr Martinek’s team concluded, “The incidence of high-grade intraepithelial neoplasia and adenocarcinoma is low in patients with adequately treated Barrett's esophagus”.

“The annual risk of developing high-grade intraepithelial neoplasia or adenocarcinoma is 0.21 %”.

Endoscopy 2008; 40: 711-6

15 September 2008

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