TY - JOUR
T1 - Histologic evaluation of resection specimens obtained at 293 endoscopic resections in Barrett's esophagus
AU - Peters, Femke P.
AU - Brakenhoff, Klasina P. M.
AU - Curvers, Wouter L.
AU - Rosmolen, Wilda D.
AU - Fockens, Paul
AU - ten Kate, Fiebo J. W.
AU - Krishnadath, Kausilia K.
AU - Bergman, Jacques J. G. H. M.
PY - 2008
Y1 - 2008
N2 - BACKGROUND: Evidence-based selection criteria for endoscopic resection (ER) of Barrett's neoplasia are scarce. OBJECTIVE: To study the histopathology of ER specimens of Barrett's neoplasia and correlate this with endoscopic characteristics to make recommendations for patient management. DESIGN, SETTING, INTERVENTIONS: Histology and correlating endoscopy reports of specimens obtained at 293 consecutive ERs performed at a Dutch tertiary referral center between 2000 and 2006 were reviewed. MAIN OUTCOME MEASUREMENTS: Histologic findings in ER specimens and their relation with endoscopic characteristics. RESULTS: A total of 150 ERs were performed for focal lesions: 16% type 0-I, 23% 0-IIa, 7% 0-IIb, 3% 0-IIc, 9% 0-IIa-IIb, and 42% 0-IIa-IIc; and 143 for flat mucosa. Histology revealed no dysplasia in 57 ERs, low-grade intraepithelial neoplasia in 52, high-grade intraepithelial neoplasia in 104, T1m in 61, and T1sm in 17; in two cancers, infiltration depth was not assessable because of artifacts. Type 0-I and 0-IIc lesions significantly more often penetrated the submucosa (P = .009): 60% were G1 cancers, 23% were G2 cancers, and 18% were G3 cancers. G2-G3 cancers significantly more often invaded the submucosa (P < .001) or had positive vertical margins (P = .015). Histology of ER specimens led to a change in diagnosis in 49% of the focal lesions and a relevant change in treatment policy in 30%. LIMITATIONS: A retrospective study. CONCLUSIONS: ER is a valuable diagnostic tool that frequently leads to a change in treatment policy. Most endoscopically resected early Barrett's neoplasia are 0-II type, G1 mucosal neoplasia. Submucosal infiltration is more often encountered in type 0-I and 0-IIc lesions and in G2-G3 cancers
AB - BACKGROUND: Evidence-based selection criteria for endoscopic resection (ER) of Barrett's neoplasia are scarce. OBJECTIVE: To study the histopathology of ER specimens of Barrett's neoplasia and correlate this with endoscopic characteristics to make recommendations for patient management. DESIGN, SETTING, INTERVENTIONS: Histology and correlating endoscopy reports of specimens obtained at 293 consecutive ERs performed at a Dutch tertiary referral center between 2000 and 2006 were reviewed. MAIN OUTCOME MEASUREMENTS: Histologic findings in ER specimens and their relation with endoscopic characteristics. RESULTS: A total of 150 ERs were performed for focal lesions: 16% type 0-I, 23% 0-IIa, 7% 0-IIb, 3% 0-IIc, 9% 0-IIa-IIb, and 42% 0-IIa-IIc; and 143 for flat mucosa. Histology revealed no dysplasia in 57 ERs, low-grade intraepithelial neoplasia in 52, high-grade intraepithelial neoplasia in 104, T1m in 61, and T1sm in 17; in two cancers, infiltration depth was not assessable because of artifacts. Type 0-I and 0-IIc lesions significantly more often penetrated the submucosa (P = .009): 60% were G1 cancers, 23% were G2 cancers, and 18% were G3 cancers. G2-G3 cancers significantly more often invaded the submucosa (P < .001) or had positive vertical margins (P = .015). Histology of ER specimens led to a change in diagnosis in 49% of the focal lesions and a relevant change in treatment policy in 30%. LIMITATIONS: A retrospective study. CONCLUSIONS: ER is a valuable diagnostic tool that frequently leads to a change in treatment policy. Most endoscopically resected early Barrett's neoplasia are 0-II type, G1 mucosal neoplasia. Submucosal infiltration is more often encountered in type 0-I and 0-IIc lesions and in G2-G3 cancers
U2 - https://doi.org/10.1016/j.gie.2007.08.039
DO - https://doi.org/10.1016/j.gie.2007.08.039
M3 - Article
C2 - 18155214
SN - 0016-5107
VL - 67
SP - 604
EP - 609
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 4
ER -