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 27 May 2018

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News

Risk stratification of Barrett's esophagus

Endoscopic and histologic features of Barrett's esophagus at initial diagnosis are predictive of index high-grade dysplasia, find doctors in the American Journal of Gastroenterology.

News image

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In this study, doctors from Kansas, USA, determined which features of Barrett's esophagus predict the prevalence and incidence of Barrett's high-grade dysplasia and adenocarcinoma.

The team evaluated 550 patients with newly-diagnosed Barrett's esophagus.

They examined a number of features including age, race, gender, length of Barrett's esophagus, size of a hiatal hernia, and severity of dysplasia at index diagnosis.

The team also considered gastric Helicobacter pylori infection status, and type of medical acid-reflux treatment.

The team found that regression analysis identified 3 factors significantly associated with index diagnosis of high-grade dysplasia or adenocarcinoma. The factors they identified were large hiatal hernia, longer Barrett's length, and absence of H. pylori infection.

Overall, 324 patients with Barrett's esophagus entered the surveillance protocol.

The team identified 5 factors predictive of the time to progression of Barrett's esophagus. The factors included dysplasia at index diagnosis, severity of dysplasia during surveillance, length of Barrett's epithelium, size of hiatal hernia, and gastric H. pylori infection.

Dr Allan Weston's team concluded, "Endoscopic and histologic features of Barrett's esophagus at initial diagnosis are predictive of index high-grade dysplasia and cancer as well as with risk of Barrett's esophagus progression".

Am J Gastroenterol 2004; 99(9): 1657-66
27 August 2004

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