Spatial predisposition of dysplasia in Barrett's esophagus segments: a pooled analysis of the SURF and AIM dysplasia trials.

The American Journal of Gastroenterology
Cary C CottonNicholas J Shaheen

Abstract

Surveillance endoscopy detects dysplasia within Barrett's esophagus (BE) and dictates treatment. Current biopsy regimens recommend uniformly spaced random biopsies. We assessed the distribution of dysplasia in BE to develop evidence-based biopsy regimens. We performed analysis of the distribution of dysplasia within BE using pretreatment biopsy data from two randomized controlled trials (RCTs) of radiofrequency ablation for dysplastic BE: the SURF (Surveillance vs. Radiofrequency Ablation) trial and the AIM Dysplasia (Ablation of Intestinal Metaplasia (AIM) Containing Dysplasia) trial. We used generalized linear models with generalized estimating equations (GEE) to estimate prevalence differences for dysplasia depending on the standardized location of biopsies. We performed Monte Carlo simulation of biopsy regimens to estimate their yield for any dysplasia within segments. Dysplasia preferentially resides in the proximal-most half of the BE segment that is almost twice as likely to demonstrate dysplasia as the distal-most quartile. In pooled analysis, compared with the distal-most quarter, the prevalence difference in the proximal-most quarter was 22.6%, in the second proximal-most quarter 23.1%, and in the second distal-most q...Continue Reading

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May 27, 2017·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Benjamin Michael AllansonMarian Priyanthi Kumarasinghe
Mar 6, 2018·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·M HarrisonP Sharma
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Mar 20, 2021·Current Treatment Options in Gastroenterology·Ying Gibbens, Prasad G Iyer
Mar 7, 2018·Gastroenterology·Martin A EversonRehan Haidry

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