Acetic acid‐enhanced magnification endoscopy in the diagnosis of specialized intestinal metaplasia, dysplasia and early cancer in Barrett's oesophagus

Fortun, Paul; Anagnostopoulos, George K.; Kaye, P; James, Martin; Foley, Steve; Samuel, Sunil; Shonde, Anthony; Badreldin, Rawya; Campbell, E.; Hawkey, C. J.; Ragunath, Krish

doi:10.1111/j.1365-2036.2006.02823.x

Cited by 71 publications

(33 citation statements)

References 24 publications

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“…While no randomised controlled trials for its use in the oesophagus exist, cohort studies have demonstrated effectiveness in the identification of dysplasia. The sensitivity for the identification of neoplasia has been suggested to be 71-100%, with a specificity between 80 and 99% (Vázquez-Iglesias et al 2007;Gossner et al 2005;Fortun et al 2006;Longcroft-Wheaton et al 2010). We believe that this is the dye of the future in the evaluation of Barrett's.…”

Section: Oesophageal Cancermentioning

confidence: 86%

Endoscopic Methods

Longcroft‐Wheaton¹,

Bhandari²

2011

Inflammation and Gastrointestinal Cancers

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Endoscopic methods to recognise and treat early gastrointestinal malignancies have increased in recent years. This has resulted in more lesions being diagnosed at an early stage and a shift away from invasive surgery towards endoscopic resection. However, it is necessary for the endoscopist to understand the key principles behind advanced endoscopic diagnosis and the new therapeutic options available. This chapter will review the advances in endoscopic techniques and methods which are changing the way we diagnose and treat these cancers. It will examine the general principles behind advanced endoscopy and then examine their application in Barrett's neoplasia, gastric cancer and the dysplasia associated lesions or masses associated with ulcerative colitis. It will focus on the best techniques for each of the above pathology.

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Section: Oesophageal Cancermentioning

confidence: 86%

Endoscopic Methods

Longcroft‐Wheaton¹,

Bhandari²

2011

Inflammation and Gastrointestinal Cancers

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“…Chromoendoscopy uses a stain (eg, methylene blue, Lugol's iodine, crystal violet, or acetic acid) that is applied with a spray catheter. The stain highlights the mucosal pit pattern, which can distinguish BE from squamous mucosa, and in conjunction with magnification, endoscopy appears to be accurate for neoplasia [32,33]. Narrow-band imaging uses a higher intensity of blue light than found in white light, highlighting the pit pattern (similarly to chromoendoscopy) and the vascular pattern.…”

Section: Novel Endoscopic Imaging Techniquesmentioning

confidence: 96%

“…Magnification endoscopy allows for detailed visualization of the mucosal surface; an irregular or distorted pit pattern appears to be closely associated with high-grade dysplasia or cancer [32,33]. Confocal laser microscopy also magnifies the mucosa and allows for visualization up to 250 m below the surface.…”

Section: Novel Endoscopic Imaging Techniquesmentioning

confidence: 99%

Screening for esophageal cancer and Barrett’s esophagus

Rubenstein¹,

Inadomi

2007

Curr GERD Rep

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The incidence of esophageal adenocarcinoma is rapidly increasing. Because endoscopically recognizing the associated premalignant condition (Barrett's esophagus) is feasible, many have recommended endoscopic screening and surveillance to decrease mortality from this cancer. However, such a strategy remains controversial, because it is impaired by poor ability to select high-risk patients for screening, limited ability to stratify patients on the risk of progression to cancer, and unproven efficacy for reducing mortality. This review summarizes the published guideline recommendations for screening and surveillance for esophageal adenocarcinoma, the limitations of such a strategy, and emerging progress toward a more rational, effective strategy for reducing mortality from this increasingly common and deadly cancer.

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“…This is a difficulty highlighted by this case study. There has been interest in using endoscopic dyes (methylene blue and acetic acid) to target biopsies in order to increase the yield of IM and dysplasia in the sampling material; however, the results have been disappointing except in expert hands (Canto et al, 2001;Fortun et al, 2006). New imaging technologies [narrow-band imaging (NBI) and autofluorescence] have recently been introduced to improve the diagnostic power of endoscopy.…”

Section: Early Diagnosis and Biomarkers Of Progressionmentioning

confidence: 99%

Clinical puzzle: Barrett’s oesophagus

Pietro

Peters

Fitzgerald

2008

Disease Models &Amp; Mechanisms

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The incidence of oesophageal adenocarcinoma has increased dramatically in the Western world over the past two decades. Owing to its dismal 5-year prognosis in advanced stages, early diagnosis is required in order to improve survival rates. Barrett’s oesophagus (Barrett’s) has been recognised as a pre-cancerous condition generally associated with chronic and severe gastro-oesophageal reflux disease (GORD). Barrett’s is defined as the substitution of the normal stratified squamous epithelium of the oesophagus with a columnar cell lining with intestinal-type differentiation; a phenomenon commonly referred to as intestinal metaplasia. Clinical challenges include finding cost-effective ways to identify patients with Barrett’s, stratifying them according to their cancer risk and improving the diagnostic potential of endoscopic sampling. Research has generally focused on identifying tissue biomarkers to predict cancer risk in these patients. The oesophagus is easily accessible, making it possible to work with human samples, but most studies have been retrospective and underpowered. Endoscopic surveillance programmes are problematic due to sampling bias and the subjective grading of dysplasia. The lack of an animal model has hampered studies to elucidate markers of the transition from Barrett’s to cancer and to test potential therapeutics. However, a number of in vitro model systems are ripe for further development into more physiologically complete systems.

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Acetic acid‐enhanced magnification endoscopy in the diagnosis of specialized intestinal metaplasia, dysplasia and early cancer in Barrett's oesophagus

Abstract: SUMMARY BackgroundBarrett's surveillance is prone to sampling error.

Cited by 71 publications

References 24 publications

Endoscopic Methods

Endoscopic Methods

Screening for esophageal cancer and Barrett’s esophagus

Clinical puzzle: Barrett’s oesophagus

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