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Erschienen in: Esophagus 2/2016

25.08.2015 | Original Article

Prevalence of esophageal neoplasia in short-segment versus long-segment Barrett’s esophagus

verfasst von: Joy Chang, Kenneth Fasanella, Jennifer Chennat, Jon Davison, Kevin McGrath

Erschienen in: Esophagus | Ausgabe 2/2016

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Abstract

Background

With heightened awareness of the increasing rate of esophageal adenocarcinoma and success of endotherapy for Barrett’s neoplasia, our Barrett’s center has seen a rise in referrals for evaluation and management of Barrett’s esophagus. We sought to compare the prevalence of neoplasia in patients with short- (<3 cm) versus long-segment Barrett’s esophagus (≥3 cm) referred to our Barrett’s center.

Methods

We performed a retrospective analysis of endoscopic procedures and pathology reports in adult patients (age >18) referred to our Barrett’s center over a 6-year period. Neoplasia was defined as low-grade dysplasia, high-grade dysplasia and superficial esophageal adenocarcinoma. Outcome measures included the prevalence of neoplasia in short- vs long-segment Barrett’s esophagus.

Results

Four-hundred and eighty-five patients (74 % male) were identified; 51 % had short-segment and 49 % had long-segment Barrett’s esophagus. The prevalence of neoplasia in short- vs long-segment Barrett’s esophagus was 33.6 vs 59.1 % (low-grade dysplasia 8.0 vs 14.5 %, high-grade dysplasia 12.8 vs 24.7 %, esophageal adenocarcinoma 12.8 vs 20.0 %). Long-segment Barrett’s esophagus was associated with 2.55-fold increase in odds of neoplasia relative to the short-segment group (OR 2.55, p < 0.001, CI 1.73–3.76).

Conclusion

Neoplasia was more prevalent in patients with long-segment Barrett’s. Surprisingly, 23.4 % of patients with an “irregular Z line” harbored advanced neoplasia (high grade dysplasia or esophageal adenocarcinoma) in our biased referral population. This suggests that patients with an “irregular Z line” should be biopsied and, if intestinal metaplasia is detected, surveyed per established Barrett’s esophagus guidelines.
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Metadaten
Titel
Prevalence of esophageal neoplasia in short-segment versus long-segment Barrett’s esophagus
verfasst von
Joy Chang
Kenneth Fasanella
Jennifer Chennat
Jon Davison
Kevin McGrath
Publikationsdatum
25.08.2015
Verlag
Springer Japan
Erschienen in
Esophagus / Ausgabe 2/2016
Print ISSN: 1612-9059
Elektronische ISSN: 1612-9067
DOI
https://doi.org/10.1007/s10388-015-0507-3

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