scholarly journals Accuracy of Preoperative Endoscopy in Determining Tumor Location Required for Surgical Planning for Esophagogastric Junction Cancer

2021 ◽  
Vol 10 (15) ◽  
pp. 3371
Author(s):  
Koichi Okumura ◽  
Yudai Hojo ◽  
Toshihiko Tomita ◽  
Tsutomu Kumamoto ◽  
Tatsuro Nakamura ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Esophagogastric Junction ◽  
Narrow Band Imaging ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Tumor Location ◽  
Concordance Rate ◽  
Diagnostic Endoscopy ◽  
Esophageal Invasion

Purpose: The surgical strategy for esophagogastric junction (EGJ) cancer depends on the tumor location as measured relative to the EGJ line. The purpose of this study was to clarify the accuracy of diagnostic endoscopy in different clinicopathological backgrounds. Methods: Subjects were 74 consecutive patients with abdominal esophagus to upper gastric cancer who underwent surgical resection. Image-enhanced endoscopy with narrow-band imaging (NBI) was used to determine the EGJ line, prioritizing the presence of palisade vessels, followed by the upper end of gastric folds, as a landmark. The relative positional relationship between the tumor epicenter and the EGJ line was classified into six categories, and the agreement between endoscopic and pathologic diagnoses was examined to evaluate prediction accuracy. Results: The concordance rate of 69 eligible cases was 87% with a kappa coefficient (K) of 0.81. The palisade vessels were observed in 62/69 patients (89.9%). Of the 37 pathological EGJ cancers centered within 2 cm above and below the EGJ line, Barrett’s esophagus was found to be a significant risk factor for discordance (risk ratio, 4.40; p = 0.042); the concordance rate of 60% (K = 0.50) in the Barrett’s esophagus group was lower than the rate of 91% (K = 0.84) in the non-Barrett’s esophagus group. In five of six discordant cases, the EGJ line was estimated to be proximal to the actual line. Conclusion: Diagnostic endoscopy is beneficial for estimating the location of EGJ cancer, with a risk of underestimating esophageal invasion length in patients with Barrett’s esophagus.

scholarly journals Immunoreactivity of cytokeratins 7 and 20 in goblet cells and columnar blue cells in patients with endoscopic evidence of Barrett's esophagus

2009 ◽  
Vol 46 (2) ◽  
pp. 127-131 ◽  
Author(s):  
João Carlos Cantarelli Jr. ◽  
Renato Borges Fagundes ◽  
Luise Meurer ◽  
Marta Pires da Rocha ◽  
André Nicola ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Barrett’S Esophagus ◽  
Alcian Blue ◽  
Barrett's Esophagus ◽  
Immunohistochemical Staining ◽  
Esophagogastric Junction ◽  
Cell Types ◽  
Goblet Cells ◽  
Cytokeratin 20 ◽  
Cytokeratin 7

CONTEXT: Barrett's esophagus is characterized by the presence of goblet cells. However, when alcian-blue is utilized, another type of cells, called columnar blue cells, is frequently present in the distal esophagus of patients with endoscopic evidence of Barrett's esophagus. Cytokeratin 7 and 20 immunoreactivity has been previously studied in areas of intestinal metaplasia at the esophagogastric junction. However, the expression of these cytokeratins in columnar blue cells has not been characterized. OBJECTIVE: To compare the expression of cytokeratin 7 and 20 in goblet cells and columnar blue cells in patients with endoscopic evidence of Barrett's esophagus. METHODS: Biopsies from 86 patients with endoscopic evidence of Barrett's esophagus were evaluated. The biopsies were stained for cytokeratin 7 and 20. RESULTS: Goblet cells were present in 75 cases and columnar blue cells in 50 cases. Overall, cytokeratin 7 expression was similar in goblet cells and columnar blue cells (P = 0.25), while cytokeratin 20 was more common in goblet cells (P <0.001). In individuals with both cell types, however, cytokeratin 7 staining was the same in goblet and columnar blue cells in 95% of the cases, and cytokeratin 20 staining was the same in 77%. CONCLUSION: Goblet cells and columnar blue cells have similar immunohistochemical staining patterns for cytokeratins 7 and 20 in patients with endoscopic evidence of Barrett's esophagus.

scholarly journals Is Malignant Potential of Barrett’s Esophagus Predictable by Endoscopy Findings?

Life ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 244
Author(s):  
Yuji Amano ◽  
Norihisa Ishimura ◽  
Shunji Ishihara
Keyword(s):  
Protein Expression ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Cellular Proliferation ◽  
Narrow Band Imaging ◽  
Malignant Potential ◽  
Cyclooxygenase 2 ◽  
Neoplastic Progression ◽  
White Light Endoscopy ◽  
Endoscopic Findings

Given that endoscopic findings can be used to predict the potential of neoplastic progression in Barrett’s esophagus (BE) cases, the detection rate of dysplastic Barrett’s lesions may become higher even in laborious endoscopic surveillance because a special attention is consequently paid. However, endoscopic findings for effective detection of the risk of neoplastic progression to esophageal adenocarcinoma (EAC) have not been confirmed, though some typical appearances are suggestive. In the present review, endoscopic findings that can be used predict malignant potential to EAC in BE cases are discussed. Conventional results obtained with white light endoscopy, such as length of BE, presence of esophagitis, ulceration, hiatal hernia, and nodularity, are used as indicators of a higher risk of neoplastic progression. However, there are controversies in some of those findings. Absence of palisade vessels may be also a new candidate predictor, as that reveals degree of intense inflammation and of cyclooxygenase-2 protein expression with accelerated cellular proliferation. Furthermore, an open type of mucosal pattern and enriched stromal blood vessels, which can be observed by image-enhanced endoscopy, including narrow band imaging, have been confirmed as factors useful for prediction of neoplastic progression of BE because they indicate more frequent cyclooxygenase-2 protein expression along with accelerated cellular proliferation. Should the malignant potential of BE be shown predictable by these endoscopic findings, that would simplify methods used for an effective surveillance, because patients requiring careful monitoring would be more easily identified. Development in the near future of a comprehensive scoring system for BE based on clinical factors, biomarkers and endoscopic predictors is required.

Feasibility of a simplified narrow-band imaging classification system for Barrett’s esophagus for novice endoscopists

2019 ◽  
Vol 54 (7) ◽  
pp. 587-596 ◽  
Author(s):  
Hiroto Furuhashi ◽  
Kenichi Goda ◽  
Yuichi Shimizu ◽  
Masayuki Kato ◽  
Masakazu Takahashi ◽  
...  
Keyword(s):  
Barrett’S Esophagus ◽  
Classification System ◽  
Barrett's Esophagus ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Imaging Classification

scholarly journals Systematic assessment with I-SCAN magnification endoscopy and acetic acid improves dysplasia detection in patients with Barrett’s esophagus

Endoscopy ◽  
2017 ◽  
Vol 49 (12) ◽  
pp. 1219-1228 ◽  
Author(s):  
Gideon Lipman ◽  
Raf Bisschops ◽  
Vinay Sehgal ◽  
Jacobo Ortiz-Fernández-Sordo ◽  
Rami Sweis ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Barrett’S Esophagus ◽  
Classification System ◽  
Barrett's Esophagus ◽  
Narrow Band Imaging ◽  
Clinical Scenario ◽  
High Definition ◽  
Systematic Assessment ◽  
Magnification Endoscopy ◽  
Before And After

Abstract Background and study aims Enhanced endoscopic imaging with chromoendoscopy may improve dysplasia recognition in patients undergoing assessment of Barrett’s esophagus (BE). This may reduce the need for random biopsies to detect more dysplasia. The aim of this study was to assess the effect of magnification endoscopy with I-SCAN (Pentax, Tokyo, Japan) and acetic acid (ACA) on dysplasia detection in BE using a novel mucosal and vascular classification system. Methods BE segments and suspicious lesions were recorded with high definition white-light and magnification endoscopy enhanced using all I-SCAN modes in combination. We created a novel mucosal and vascular classification system based on similar previously validated classifications for narrow-band imaging (NBI). A total of 27 videos were rated before and after ACA application. Following validation, a further 20 patients had their full endoscopies recorded and analyzed to model use of the system to detect dysplasia in a routine clinical scenario. Results The accuracy of the I-SCAN classification system for BE dysplasia improved with I-SCAN magnification from 69 % to 79 % post-ACA (P = 0.01). In the routine clinical scenario model in 20 new patients, accuracy of dysplasia detection increased from 76 % using a “pull-through” alone to 83 % when ACA and magnification endoscopy were combined (P = 0.047). Overall interobserver agreement between experts for dysplasia detection was substantial (0.69). Conclusions A new I-SCAN classification system for BE was validated against similar systems for NBI with similar outcomes. When used in combination with magnification and ACA, the classification detected BE dysplasia in clinical practice with good accuracy.Trials registered at ISRCTN (58235785).

scholarly journals Seattle protocol vs narrow band imaging guided biopsy in screening of Barrett's esophagus in gastroesophageal reflux disease patients

Medicine ◽  
2020 ◽  
Vol 99 (8) ◽  
pp. e19261
Author(s):  
Ahmed Elsheaita ◽  
Mohamed Ahmed El-Bially ◽  
Mohammed Mohammed Shamseya ◽  
Sanaa Shawky Ahmed ◽  
Marwa Ahmed Madkour ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Barrett’S Esophagus ◽  
Reflux Disease ◽  
Barrett's Esophagus ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Guided Biopsy
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