Original articleAlimentary tractSubsquamous Extension of Intestinal Metaplasia Is Detected in 98% of Cases of Neoplastic Barrett's Esophagus
Section snippets
Methods
Resection specimens gained by widespread EMR from 110 patients (92 men, 18 women; mean age, 66 years) between 2004 and 2010 were included in this retrospective study. Indication for endoscopic resection was BE with suspected or confirmed dysplasia or presumed mucosal carcinoma. Widespread EMR aimed at complete ablation of all BE tissue together with the neoplastic area(s) and in some cases additional thermal methods were done after EMR sessions (details not reported here). Histopathologic
Results
Data of all 110 patients included in this study are shown in Table 1 and Figure 1. Mean age was 66 years; the male:female ratio was 5.11:1. The most severe histologic diagnoses on a per-patient basis included early (T1) cancer in 66, high-grade intraepithelial neoplasia in 15, and low-grade epithelial neoplasia in 3 cases. Barrett length significantly correlated with increasing neoplasia grade, ranging from no neoplasia to T1b cancer (P < .0001). In 26 cases with positive biopsies at other
Discussion
Our study shows an almost regular occurrence of SSIM in patients with (neoplastic) BE. Because our analysis has been designed solely to address the question of subsquamous extension of Barrett epithelium, uses large tissue specimens from widespread EMR extending into the SQE, and includes a substantial number of patients, our findings may be considered of some general impact on BE surveillance and therapy. Our study cannot fully answer the question whether SSIM is a regular event in patients
Acknowledgments
Drs Anders, Lucks, and El-Masry contributed equally to this work.
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Conflicts of interest The authors disclose no conflicts.