"Indefinite for Dysplasia" in Barrett's Esophagus: Inflammation and DNA Content Abnormality are Significant Predictors of Early Detection of Neoplasia

Clinical and Translational Gastroenterology
Won-Tak ChoiMaria Westerhoff

Abstract

Dysplasia arising from Barrett's esophagus precedes esophageal adenocarcinoma (EAC). Cases that are difficult to diagnose as dysplastic, especially in the setting of inflammation, may be designated "indefinite for dysplasia (IND)." Although flow cytometric analysis of DNA content has shown some promise in detecting EAC, there are few reports that have specifically evaluated the outcome of IND. We analyzed a series of 96 IND patients seen at the University of Washington between 2005 and 2013 to determine the outcome of IND and to identify factors (including histologic features and DNA flow cytometric data) associated with subsequent detection of neoplasia. Twenty-five percent of IND cases were found to have low-grade dysplasia, high-grade dysplasia (HGD), or EAC within 1 year, with 37% and 47% detected within 2 and 3 years, respectively. The 1-, 2-, and 3-year detection rates of HGD or EAC were 10%, 13%, and 20%, respectively. Active inflammation (hazard ratio (HR)=3.4, P=0.0005) and abnormal DNA content (HR=5.7, P=0.003) were significant risk factors of neoplasia. When active inflammation and DNA flow cytometric results were considered together, the HR for the combined markers was 18.8 (P<0.0001). The sensitivity and specificit...Continue Reading

References

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Citations

Sep 8, 2016·World Journal of Gastrointestinal Pharmacology and Therapeutics·Prashanthi N ThotaXiu-Li Liu
May 14, 2020·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Andrew J HennBrian J Hanson
Aug 20, 2019·Gastrointestinal Endoscopy·Rajesh KrishnamoorthiPrasad G Iyer
Feb 7, 2021·Gastrointestinal Endoscopy·Richard PhillipsMassimiliano di Pietro
Apr 27, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Tarek SawasUNKNOWN Post-Endoscopy Esophageal Adenocarcinoma Consensus Panel

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Methods Mentioned

BETA
biopsy
flow
biopsies
flow cytometry
DNA

Software Mentioned

Hmisc
Multicycle
R
survival
rms
Power Path

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Barrett Esophagus

Barrett’s esophagus if a serious complication of gastroesophageal reflux disease during which the normal esophageal lining changes to tissue that resembles intestinal lining. Here is the latest research.

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