Search results for "Barrett esophagus"

Aurora-A overexpression as an early marker of reflux-related columnar mucosa and Barrett's oesophagus.

2007

Abstract BACKGROUND: The development of oesophageal adenocarcinoma is generally closely associated with the presence of a specialised intestinal-type epithelium such as that found in Barrett's oesophagus (BO). A particular histological condition is when the distal oesophagus showing cardiac and/or fundic mucosa without intestinal metaplasia cannot be defined as 'Barrett's mucosa' [condition that we call 'columnar-lined oesophagus' (CLO)] and up till now, there has been no agreement in literature about the management of this condition. Aurora-A overexpression leads to centrosome amplification, chromosomal instability and aneuploidy in mammalian cells. PATIENTS AND METHODS: A prospective stud…

Does Cytokeratin7/20 immunoreactivity help to distinguish Barrett's esophagus from gastric intestinal metaplasia? Results of a prospective study of 7…

2005

Barrett's esophagus is a recognized risk factor for the development of esophageal dysplasia and carcinoma. Unfortunately, gastric incomplete intestinal metaplasia arising in Short Segment Barrett's esophagus can be indistinguishable histologically on hematoxylin/eosin stains. Distinct patterns of CK 7 and CK 20 immunohistochemical expression have been demonstrated to be both highly sensitive and specific for Barrett's esophagus, but have not been found in gastric metaplasia. The aim of our study was to test whether immunostaining with CK 7/20 helps to distinguish between Barrett's epithelium and gastric incomplete metaplasia. Cases of long segment Barrett's esophagus, short segment Barrett'…

"Dry biopsies" with spraying of dilute epinephrine optimize biopsy mapping of long segment Barrett's esophagus

2008

BACKGROUND AND STUDY AIMS: For surveillance of Barrett’s esophagus random stepwise four-quadrant biopsy (4QB) is recommended for detecting macroscopically occult neoplasias. Thorough performance of the systematic protocol is commonly hampered by poor visibility due to oozing from biopsy sites. Topical application of dilute epinephrine may prevent bleeding by vasoconstriction of superficial microvessels and might therefore enable ”dry biopsy” sampling. The aim of this study was to examine the safety and efficacy of spraying dilute epinephrine for optimal 4QB mapping of Barrett’s esophagus. PATIENTS AND METHODS: In this prospective, double-blind trial 40 patients with known long segment Barre…

Comparison of computed virtual chromoendoscopy and conventional chromoendoscopy with acetic acid for detection of neoplasia in Barrett's esophagus.

2007

Background and study aims Computed virtual chromoendoscopy (CVC) is a new imaging technique that enhances mucosal surface contrast and highlights the vascular pattern without the need for dye-spraying as in conventional chromoendoscopy. The aim of this prospective randomized pilot study with a crossover design was to compare CVC with conventional chromoendoscopy with acetic acid (CAA) for the detection of high grade intraepithelial neoplasia (HGIN) or early cancer in patients with Barrett's esophagus. Patients and methods 57 patients with Barrett's esophagus (mean length 3.8 cm) and a history of HGIN/early cancer or suspected HGIN/early cancer were randomly allocated to undergo either CAA o…

Indications for Anti-Reflux Surgery in Barrett's Esophagus

2014

CD1a expression by Barrett's metaplasia of gastric type may help to predict its evolution towards cancer

2005

As emerging in the recent literature, CD1a has been regarded as a molecule whose expression may reflect tumour evolution. The aim of the present work was to investigate the expression of CD1a in a series of Barrett's metaplasia (BM), gastric type (GTBM), with and without follow-up, in order to analyse whether its expression may help to diagnose this disease and to address the outcome. Indeed, GTBM may be confused sometimes with islets of ectopic gastric mucosa and its evolution towards dysplasia (Dy) or carcinoma (Ca) could not be foreseen. We showed a significant higher expression of CD1a in GTBM than in both Dy and Ca; nevertheless, the number of positive GTBM was significantly lower in t…

The Italian validation of the Montreal Global definition and classification of gastroesophageal reflux disease

2009

Recently, a Global definition and a classification of gastroesophageal reflux disease (GERD) were developed by Montreal Consensus Group, composed of international expert gastroenterologists. Guidelines and consensus documents are, however, infrequently accepted and adopted at a local level. The aim of this study was to measure the acceptance of Montreal Global definition of GERD consensus document by specialists in a single country (Italy) and to measure the linguistic, scientific, and practical differences between the international consensus document and the Italian version.A 2-day meeting was held in June 2007 in Rome, Italy, attended by 147 Italian physicians who were experts in gastroen…

Confocal laser endomicroscopy for gastrointestinal diseases.

2008

Confocal laser endomicroscopy enables in vivo microscopy of the mucosal layer of the gastrointestinal tract with subcellular resolution during ongoing endoscopy. Endomicroscopy opens the door to immediate tissue and vessel analysis. Different types of diseases can be diagnosed with optical surface and subsurface analysis. Analysis of the in vivo microarchitecture can be used for targeting biopsies to relevant areas, and subsurface imaging can unmask microscopic diseases or bacterial infection. Molecular imaging is becoming feasible, which will enable new indications in gastrointestinal endoscopy. This article reviews the current and rapidly expanding clinical data on endomicroscopy and give…

Confocal laser endomicroscopy: technical status and current indications.

2006

Confocal laser endomicroscopy is a newly introduced endoscopic tool that makes it possible to carry out confocal microscopic examination of the mucosal layer during ongoing endoscopy. Different types of tissue and diseases can be diagnosed immediately, facilitating early diagnosis of gastrointestinal cancer. Analysis of the in vivo microarchitecture is helpful in targeting biopsies to relevant areas. In addition, subsurface imaging can unmask microscopic diseases - (microscopic colitis) or bacterial infection ( HELICOBACTER PYLORI), for example. Molecular imaging is becoming feasible, and this will shortly open the door to new indications in gastrointestinal endoscopy (e.g., in vivo recepto…

The molecular changes driving the carcinogenesis in Barrett's esophagus: which came first, the chicken or the egg?

2013

Esophageal adenocarcinoma originates from columnar metaplastic epithelium of the distal esophagus. Various steps for this carcinogenetic process are known. Before the onset of high-grade dysplasia and adenocarcinoma, endoscopic surveillance is possible. However, because of the high cost of long-term surveillance, predictive factors for cancer are being evaluated to identify subjects with metaplasia who have a higher risk of developing malignancy. Molecular changes seem suitable for this purpose, but could require a high resource expenditure. While trying to identify the best predictive factors for cancer risk, molecular changes and differences in miRNA expression profile between the various…