TY - JOUR
T1 - Advances in the diagnosis and surveillance of Barrett's esophagus (with videos)
AU - The ASGE Technology Committee
AU - Trindade, Arvind J.
AU - Navaneethan, Udayakumar
AU - Aslanian, Harry R.
AU - Bhutani, Manoop S.
AU - Krishnan, K.
AU - Lichtenstein, David R.
AU - Melson, Joshua
AU - Pannala, R.
AU - Parsi, Mansour A.
AU - Schulman, Allison R.
AU - Sethi, Amrita
AU - Trikudanathan, Guru
AU - Watson, Rabindra R.
AU - Maple, John T.
N1 - Publisher Copyright:
© 2019
PY - 2019/9
Y1 - 2019/9
N2 - Background and Aims: Most patients diagnosed with esophageal adenocarcinoma do not carry a known diagnosis of Barrett's esophagus (BE), suggesting that an improved approach to screening may potentially be of benefit. The use of dysplasia as a biomarker and random biopsy protocols for its detection has limitations. In addition, detecting and appropriately classifying dysplasia in patients with known BE can be difficult. Methods: This document reviews several technologies with a recently established or potential role in the diagnosis and/or surveillance of BE as well as risk stratification for progression to esophageal adenocarcinoma. Results: Two technologies were reviewed for imaging or tissue sampling: (1) wide-area transepithelial sampling and (2) volumetric laser endomicroscopy. Four technologies were reviewed for molecular and biomarker technologies for diagnosis and risk stratification: (1) Cytosponge, (2) mutational load, (3) fluorescence in situ hybridization, and (4) immunohistochemistry. Conclusion: Several technologies discussed in this document may improve dysplasia detection in BE in a wide-field manner. Moreover, the addition of different biomarkers may aid in enhanced risk stratification to optimize approaches to surveillance or treatment for patients with BE.
AB - Background and Aims: Most patients diagnosed with esophageal adenocarcinoma do not carry a known diagnosis of Barrett's esophagus (BE), suggesting that an improved approach to screening may potentially be of benefit. The use of dysplasia as a biomarker and random biopsy protocols for its detection has limitations. In addition, detecting and appropriately classifying dysplasia in patients with known BE can be difficult. Methods: This document reviews several technologies with a recently established or potential role in the diagnosis and/or surveillance of BE as well as risk stratification for progression to esophageal adenocarcinoma. Results: Two technologies were reviewed for imaging or tissue sampling: (1) wide-area transepithelial sampling and (2) volumetric laser endomicroscopy. Four technologies were reviewed for molecular and biomarker technologies for diagnosis and risk stratification: (1) Cytosponge, (2) mutational load, (3) fluorescence in situ hybridization, and (4) immunohistochemistry. Conclusion: Several technologies discussed in this document may improve dysplasia detection in BE in a wide-field manner. Moreover, the addition of different biomarkers may aid in enhanced risk stratification to optimize approaches to surveillance or treatment for patients with BE.
UR - http://www.scopus.com/inward/record.url?scp=85065784588&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85065784588&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2019.05.004
DO - 10.1016/j.gie.2019.05.004
M3 - Article
C2 - 31113535
AN - SCOPUS:85065784588
SN - 0016-5107
VL - 90
SP - 325
EP - 334
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 3
ER -