AIM:To report the prevalence of Subsquamous intestinal metaplasia(SSIM)in patients undergoing endoscopic mucosal resection(EMR)for staging of Barrett’s esophagus(BE).METHODS:Thirty-three patients with BE associated n...AIM:To report the prevalence of Subsquamous intestinal metaplasia(SSIM)in patients undergoing endoscopic mucosal resection(EMR)for staging of Barrett’s esophagus(BE).METHODS:Thirty-three patients with BE associated neoplasia underwent EMR at our institution between September 2009 and September 2011;22 of these patients met study inclusion criteria.EMR was targeted at focal abnormalities within the BE segment.EMR was performed in standardized fashion using a cap-assisted band ligation technique,and resection specimens were assessed for the presence of SSIM.Demographic and clinical data were analyzed to determine predictors of SSIM.RESULTS:SSIM was detected in 59%of patients.SSIM was detected in 73%of patients with short segment(<3 cm)BE,and in 45%of patients with longsegment(≥3 cm)BE(P=NS).There was no association between presence/absence of SSIM and age,gender,or stage of BE-associated neoplasia.CONCLUSION:EMR detects SSIM in a majority of patients with BE-associated neoplasia.While the longterm clinical significance of SSIM remains uncertain,these results highlight the importance of EMR as an optimal diagnostic tool for staging of BE and detection of SSIM,and should further limit concerns that SSIM is purely a post-ablation phenomenon.展开更多
Barrett’s esophagus(BE)develops as a consequence of chronic esophageal acid exposure,and is the major risk factor for esophageal adenocarcinoma(EAC).The practices of endoscopic screening for—and surveillance of—BE,...Barrett’s esophagus(BE)develops as a consequence of chronic esophageal acid exposure,and is the major risk factor for esophageal adenocarcinoma(EAC).The practices of endoscopic screening for—and surveillance of—BE,while widespread,have failed to reduce the incidence of EAC.The majority of EACs are diagnosed in patients without a known history of BE,and current diagnostic tools are lacking in their ability to stratify patients with BE into those at low risk and those at high risk for progression to malignancy.Nonetheless,advances in endoscopic imaging and mucosal therapeutics have provided unprecedented opportunities for intervention for BE,and have vastly altered the approach to management of BE-associated mucosal neoplasia.展开更多
文摘AIM:To report the prevalence of Subsquamous intestinal metaplasia(SSIM)in patients undergoing endoscopic mucosal resection(EMR)for staging of Barrett’s esophagus(BE).METHODS:Thirty-three patients with BE associated neoplasia underwent EMR at our institution between September 2009 and September 2011;22 of these patients met study inclusion criteria.EMR was targeted at focal abnormalities within the BE segment.EMR was performed in standardized fashion using a cap-assisted band ligation technique,and resection specimens were assessed for the presence of SSIM.Demographic and clinical data were analyzed to determine predictors of SSIM.RESULTS:SSIM was detected in 59%of patients.SSIM was detected in 73%of patients with short segment(<3 cm)BE,and in 45%of patients with longsegment(≥3 cm)BE(P=NS).There was no association between presence/absence of SSIM and age,gender,or stage of BE-associated neoplasia.CONCLUSION:EMR detects SSIM in a majority of patients with BE-associated neoplasia.While the longterm clinical significance of SSIM remains uncertain,these results highlight the importance of EMR as an optimal diagnostic tool for staging of BE and detection of SSIM,and should further limit concerns that SSIM is purely a post-ablation phenomenon.
基金supported by the National Institutes of Health:grant R01CA140574 to Dr.Hur.
文摘Barrett’s esophagus(BE)develops as a consequence of chronic esophageal acid exposure,and is the major risk factor for esophageal adenocarcinoma(EAC).The practices of endoscopic screening for—and surveillance of—BE,while widespread,have failed to reduce the incidence of EAC.The majority of EACs are diagnosed in patients without a known history of BE,and current diagnostic tools are lacking in their ability to stratify patients with BE into those at low risk and those at high risk for progression to malignancy.Nonetheless,advances in endoscopic imaging and mucosal therapeutics have provided unprecedented opportunities for intervention for BE,and have vastly altered the approach to management of BE-associated mucosal neoplasia.
