Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 24 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Necessity of biopsy surveillance in Barrett's esophagus

Careful endoscopic observation and stepwise 4 quadrant biopsy represent the gold standard in the surveillance of Barrett's esophagus, find researchers in the January issue of Gut.

News image

fiogf49gjkf04

Endoscopic surveillance, including stepwise 4 quadrant biopsies (4QB), is the standard approach in patients with Barrett’s esophagus (BE).

However, methods such as staining with methylene blue (MB) and tissue autofluorescence (AF) have been suggested to reduce the number of biopsies performed.

In this study, a team from Germany assessed the sensitivity and specificity of these methods, compared to endoscopy with 4QB, in the surveillance of a mixed BE population.

The research team included 35 consecutive BE patients in the study. Patients had a mean age of 64.9 years, and included 30 men and 5 women.

AF endoscopy was followed by high resolution video endoscopy (VE) plus tissue staining with 0.5% MB.

In addition, the team took biopsies from any suspicious area found on any of the aBEve tests, in addition to 4QB every 2 cm.

They classified the results as either positive or negative for the various tests used.
Methylene blue and tissue autofluorescence not suitable techniques for reducing the high numbers of routine biopsies.
Gut

Histopathological results were used as the reference standard.

The research team took a total of 345 biopsies.

Of these, 88 showed low grade dysplasia (LGD), 19 showed high grade dysplasia (HGD), and 12 showed carcinoma.

The team found that sensitivity and specificity rates for AF and MB for the diagnosis of cancer or dysplasia, versus BE mucosa without dysplasia, were 21%/91% and 37%/91%, respectively.

Furthermore 4QB revealed 5 cancer or HGD areas, and 76 LGD areas not detected by AF, MB, or VE.

The additional yield of MB and AF, over VE with 4QB, concerned only 1 HGD area and 7 LGD areas.

Dr Egger’s team concluded, “Due to their low sensitivity, AF and MB are not suitable techniques for reducing the high numbers of routine biopsies needed for finding additional foci of HGD or cancer”.

“Careful endoscopic observation and stepwise four quadrant biopsy therefore still represent the gold standard for surveillance of Barrett’s esophagus”.

Gut 2003; 52: 18-23
16 December 2002

Go to top of page Email this page Email this page to a colleague

 24 January 2018 
Risk factors underlying previously undiagnosed cirrhosis
 24 January 2018 
Ethnicity influences phenotype in IBD
 24 January 2018 
Bariatric surgery vs medical obesity treatment
 23 January 2018 
Atrophic gastritis after H. pylori eradication
 23 January 2018 
Ectopic pregnancy in women with IBD
 23 January 2018 
Celiac disease in IBS in the USA
 22 January 2018 
Costs of biologic therapies for IBD in the USA
 22 January 2018 
Western vs Asian guidelines for colon cancer management
 22 January 2018 
Improving symptoms in GERD
 19 January 2018 
Predicting the risk of early surgery in Crohn’s
 19 January 2018 
Ileoanal pouch microbiota
 19 January 2018 
Lifestyle intervention vs gastric bypass for obesity and diabetes
 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us