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. 2018 Apr;14(4):233-239.

Evaluation of Dysplasia in Barrett Esophagus

Seth A Gross  1 , Joseph Kingsbery  1 , Janice Jang  1 , Michelle Lee  1 , Abraham Khan  1
Affiliations

Evaluation of Dysplasia in Barrett Esophagus

Seth A Gross et al. Gastroenterol Hepatol (N Y). 2018 Apr.

Abstract

Barrett esophagus (BE) is the precursor lesion to adenocarcinoma of the esophagus. The current surveillance strategy of 4-quadrant Seattle protocol biopsies has been associated with sampling error and missing higher-risk lesions, and there is often less adherence to endoscopic surveillance with long segments. Advancements in endoscopic imaging and sampling techniques allow for better surveillance of BE, particularly when assessing for dysplasia. This article highlights the key endoscopic imaging and sampling advancements in the evaluation of dysplasia in BE.

Keywords: Barrett esophagus; chromoendoscopy; confocal laser endomicroscopy; dysplasia; narrow-band imaging; volumetric laser endomicroscopy.

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Conflict of interest statement

The authors have no relevant conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
The Prague C&M classification is used to endoscopically grade Barrett esophagus. Prague C3 and M6 are shown in the figure, in which C represents the circumferential difference in endoscope insertion distance between the positions recorded for the gastroesophageal junction (GEJ) and the proximal margin of the circumferential Barrett epithelium, and M represents the difference in endoscope insertion distance between the positions recorded for the GEJ and the proximal margin of the longest tongue-like segment of Barrett epithelium.
Figure 2.
Figure 2.
A narrow-band image of a distal esophagus demonstrates high-grade dysplasia in an area of Barrett esophagus.
Figure 3.
Figure 3.
Confocal laser endomicroscopy image shows enlarged pleomorphic cells that are characteristic of Barrett esophagus with high-grade dysplasia.
Figure 4.
Figure 4.
Volumetric laser endomicroscopy image shows large glands below the mucosal surface with loss of layering that is consistent with Barrett esophagus with high-grade dysplasia.
See this image and copyright information in PMC

References

    1. Shaheen NJ, Falk GW, Iyer PG, Gerson LB American College of Gastroenterology. ACG Clinical Guideline: diagnosis and management of Barrett’s esophagus. Am J Gastroenterol. 2016;111(1):30–50. - PMC - PubMed
    1. Davis-Yadley AH, Neill KG, Malafa MP, Pena LR. Advances in the endoscopic diagnosis of Barrett esophagus. Cancer Control. 2016;23(1):67–77. - PubMed
    1. Evans JA, Early DS, Fukami N, et al. ASGE Standards of Practice Committee; Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointest Endosc. 2012;76(6):1087–1094. - PubMed
    1. Ireland CJ, Thompson SK, Laws TA, Esterman A. Risk factors for Barrett’s esophagus: a scoping review. Cancer Causes Control. 2016;27(3):301–323. - PubMed
    1. Macías-García F, Domínguez-Muñoz JE. Update on management of Barrett’s esophagus. World J Gastrointest Pharmacol Ther. 2016;7(2):227–234. - PMC - PubMed

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