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News

Low-grade dysphasia a risk factor for esophageal cancer

The extent of low-grade dysplasia is a risk factor for esophageal adenocarcinoma in Barrett's, reports March's issue of the American Journal of Gastroenterology

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Previous studies that evaluated extent of high-grade dysplasia as a risk factor for esophageal Aden carcinoma in Barrett's esophagus were conflicting.

No prior study has evaluated extent of low-grade dysplasia as a risk factor.

Dr Robert Odze and colleagues from Massachusetts evaluated the extent of low-grade dysplasia and high-grade dysplasia as risk factors for progression to esophageal adenocarcinoma.

The team evaluated baseline biopsies from 77 Barrett's esophagus patients with dysphasia.

Of these patients, 44 progressed to esophageal Aden carcinoma, and 33 did not progress during follow-up.

The total numbers of low-grade dysplasia and high-grade dysplasia crypts were determined separately by counting all crypts and the extent of dysphasia.

The team then correlated low-grade, high-grade, and total dysplasia with esophageal adenocarcinoma outcome.

The researcher found 31 and 46 patients had a maximum diagnosis of low-grade dysplasia and high-grade dysplasia, respectively.

The team also stratified the crypts by dysplasia grade.

The mean number of low-grade dysplasia crypts per patient was borderline higher in progressors compared with nonprogressors.

The researchers found that the mean proportion of low-grade dysplasia crypts per patient was significantly higher in progressors.

The team observed that the mean number of high-grade dysplasia crypts per patient was not associated with esophageal adenocarcinoma outcome.

The researchers noted that the mean proportion of high-grade dysplasia crypts per patient was associated with esophageal adenocarcinoma outcome.

Dr Odze's team concluded, “The extent of low-grade dysplasia is a significant risk factor for the development of esophageal adenocarcinoma in Barrett's esophagus in this study.”

“Although the presence of high-grade dysplasia is significantly associated with a greater relative risk for development of esophageal adenocarcinoma, the extent of high-grade dysplasia was not an independent risk factor for progression.”

Am J Gastroenterol 2007: 102(3): 483-93
07 March 2007

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