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. 2022 Sep 9:35:e1674.
doi: 10.1590/0102-672020220002e1674. eCollection 2022.

RISK OF PRENEOPLASTIC LESIONS IN MUCOSAL PROJECTIONS OF DIFFERENT SIZES OF THE COLUMNAR EPITHELIUM IN THE LOWER ESOPHAGUS

Hairton Copetti  1 , Leonardo Copetti  1 , Laura Copetti  1 , Giulliano Danezi Felin  2 , Giancarllo Danezi Felin  2 , Carollina Danezi Felin  3 , Fellipe Danezi Felin  4 , Vitória Chiesa  5
Affiliations

RISK OF PRENEOPLASTIC LESIONS IN MUCOSAL PROJECTIONS OF DIFFERENT SIZES OF THE COLUMNAR EPITHELIUM IN THE LOWER ESOPHAGUS

Hairton Copetti et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Background: Barrett's esophagus is an acquired condition that predisposes to the development of esophageal adenocarcinoma.

Aims: The aim of this study was to establish an association between the endoscopic and the histopathological findings regarding differently sized endoscopic columnar epithelial mucosa projections in the low esophagus, under 3.0 cm in the longitudinal extent.

Methods: This is a prospective study, including 1262 patients who were submitted to upper gastrointestinal endoscopy in the period from July 2015 to June 2017. The suspicious projections were measured and subdivided into three groups according to the sizes encountered (Group I: <0.99 cm; Group II: 1.0-1.99 cm; and Group III: 2.0-2.99 cm), and biopsies were then performed.

Results: There was a general prevalence of suspicious lesions of 6.42% and of confirmed Barrett's lesions of 1.17%, without a general significant statistical difference among groups. However, from Groups I and II to Group III, the differences were significant, showing that the greater the lesion, the higher the probability of Barrett's esophagus diagnosis. The absolute number of Barrett's lesions was 7, 9, and 6 for Groups I, II, and III, respectively.

Conclusions: The findings led to the conclusion that even projections under 3.0 cm present a similar possibility of evolution to Barrett's esophagus. If, on the one hand, short segments are more prevalent, on the other hand, the long segments have the higher probability of Barrett's esophagus diagnosis, which is why biopsies are required in all suspicious segments.

RACIONAL:: O esôfago de Barrett é uma condição adquirida que predispõe ao desenvolvimento de adenocarcinoma de esôfago.

OBJETIVOS:: Estabelecer uma associação entre os achados endoscópicos e histopatológicos em relação às projeções endoscópicas da mucosa epitelial colunar de diferentes tamanhos no esôfago, abaixo de 3,0 centímetros de extensão longitudinal.

MÉTODOS:: Foi realizado um estudo prospective incluindo 1262 pacientes submetidos à endoscopia digestiva alta, no período de julho de 2015 a junho de 2017. As projeções suspeitas foram medidas, subdivididas em 3 grupos de acordo com os tamanhos encontrados (Grupo I: <0,99 cm; Grupo II: 1,0 cm–1,99 cm; Grupo III: 2,0 cm–2,99 cm) e biópsias foram então realizadas.

RESULTADOS:: Houve prevalência geral de lesões suspeitas de 6,42% e de lesões de Barrett confirmadas de 1,17%, sem diferença estatística geral significativa entre os grupos. Porém, dos Grupos I e II, para o Grupo III, as diferenças foram significativas, mostrando que quanto maior a lesão, maior a probabilidade de diagnóstico de esôfago de Barrett. O número absoluto de lesões de Barrett foi 7, 9 e 6 para os grupos I, II e III, respectivamente.

CONCLUSÕES:: Os achados permitiram concluir que mesmo projeções abaixo de 3,0 cm apresentam possibilidade semelhante de evolução para o esôfago de Barrett. Se, por um lado os segmentos curtos são mais prevalentes, por outro os segmentos longos têm maior probabilidade de diagnóstico de esôfago de Barrett, razão pela qual são necessárias biópsias em todos os segmentos suspeitos.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Esophagogastric junction.
Figure 2
Figure 2. Mucosa projection of columnar epithelium.
Figure 3
Figure 3. Measuring clamp.
Figure 4
Figure 4. Acetic acid coloring of small area.
Figure 5
Figure 5. Measurement with graded clamp.
Figure 6
Figure 6. Area suspicious of Barrett's.
Figure 7
Figure 7. Measurement after acetic acid.
Figure 8
Figure 8. Goblet cells after Alcian blue staining.
See this image and copyright information in PMC

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