Evaluation of modified crystal violet chromoendoscopy procedure using new mucosal pit pattern classification for detection of Barrett's dysplastic lesions

Yuki, Takafumi; Amano, Yuji; Kushiyama, Yoshinori; Takahashi, Yoshiko; Ose, Takayuki; Moriyama, Ichiro; Fukuhara, Hiroshi; Ishimura, Norihisa; Koshino, Kenji; Furuta, K.; Ishihara, Shunji; Adachi, Kyoichi; Kinoshita, Yoshikazu

doi:10.1016/j.dld.2006.01.028

Cited by 22 publications

(20 citation statements)

References 22 publications

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“…We have been conducting Barrett's surveillance with crystal violet chromoendoscopy [2,14] for 2 years. In the first year, six Barrett's cancers and 15 dysplasias were found in 1963 consecutive esophagogastroduodenoscopies.…”

Section: Discussionmentioning

confidence: 99%

A case report of mucosal Barrett's cancer with vessel involvement, with special reference to indications for endoscopic mucosal ablation therapy

et al. 2006

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We present a 72-year-old female patient with mucosal Barrett's cancer. Although preoperative diagnosis suggested tumor invasion throughout the mucosal layer, she was treated by endoscopic mucosal resection at her preference. The tumor invasion depth was "m-3." However, tumor cells were observed along the endothelium of a small vein. Following endoscopic treatment, ultimately the patient underwent radical surgery. Neither residual tumor nor lymph node metastasis was found in the resected specimens. We also reviewed published reports regarding the relationship between tumor depth and vessel involvement in earlystage Barrett's cancer. In Barrett's cancer with a tumor invasion of m-3 where tumor had invaded throughout the mucosal layer, blood or lymphatic vessel invasion was observed in 12.5% of cases (6/48). However, no lymph node metastasis was found. Therefore, we considered that endoscopic mucosal ablation therapy may be applicable to treat intramucosal Barrett's cancer with a tumor invasion depth of m-3.

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Section: Discussionmentioning

confidence: 99%

A case report of mucosal Barrett's cancer with vessel involvement, with special reference to indications for endoscopic mucosal ablation therapy

et al. 2006

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“…Die Chromoendoskopie beim Barrett-Ösophagus erfolgt nach Applikation von Methylenblau [17], Kristallviolett [18] oder Indigokarmin [19]. Meistens erfolgt nach Färbung eine Vergrößerungsendos-kopie, um suspekte Areal weiter abzugrenzen und die Biopsie gezielter durchzuführen (.…”

Section: Fortschritte In Der Diagnostikunclassified

Barrett’s syndrome

Meining

2008

Gastroenterologe

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ZusammenfassungDer Barrett-Ösophagus -d. h. der Ersatz des Plattenepithels des distalen Ösophagus durch Zylinderepithel (spezialisierte intestinale Metaplasie) -entsteht im Rahmen einer gastroösophagealen Refluxkrankheit und beruht auf einer endoskopischen sowie histopathologischen Diagnose. Aufgrund eines erhöhten Entartungsrisikos sollen Patienten mit Barrett-Ösophagus leitlinienkonform in ein Überwachungsprogramm eingeschlossen werden. Problematisch in diesem Zusammenhang ist die Tatsache, dass die Diagnose sowohl der Barrett-Metaplasie als auch der BarrettNeoplasie ungenau ist. Neuerungen taten daher Not: So wurde eine neue Klassifikation generiert, neue endoskopische diagnostische Verfahren wurden auf ihre prinzipielle Machbarkeit evaluiert bzw. befinden sich noch auf dem Prüfstand. Die endoskopische Therapie der fokalen Barrett-Neoplasie (nicht Metaplasie!) ist inzwischen leitlinienkonform, das optimale endoskopische bzw. interventionelle Verfahren zur totalen Barrett-Ablation ohne Nachwirkungen (Strikturen) bleibt jedoch noch abzuwarten. In der Übersichtsarbeit wird versucht, den aktuellen Stand der "Barrettologie" klinisch orientiert wiederzugeben, Neuerungen auf ihren klinischen Benefit zu beleuchten und Strategien zum weiteren Procedere vorzuschlagen. SchlüsselwörterAutofluoreszenzendoskopie · Sampling error · Mukosektomie · Laserscanningmikroskopie · Narrow Band Imaging Barrett's syndrome AbstractBarrett's syndrome -i.e. exchange of distal esophageal plate epithelium with columnar epithelium (so-called specialized intestinal metaplasia) -appears as a gastroesophageal reflux disorder and is diagnosed via endoscopy and histopathology. Due to the greater risk of tissue degeneration, all patients with suspected Barrett's esophagus should undergo a standardized observation program. One problem in this respect is that diagnosis remains imprecise for both Barrett's metaplasia and Barrett's neoplasia. This need for more precision resulted in a new classification, and novel endoscopic diagnostic techniques have been or are still being reevaluated. Endoscopic therapy of focal Barrett's neoplasia (not metaplasia!) is now standardized, however the ideal intervention or endoscopic method for total Barrett's ablation without negative effects (in the form of strictures) has yet to be determined. This article describes the present clinical status of "Barrettology", examines the clinical benefits of newer treatment methods, and presents strategies for continued research.

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“…Recently, target biopsies using advanced imaging techniques have been reported to feature similar diagnostic proportions of specialized intestinal metaplasia with fewer biopsies and better detection rates of dysplastic lesions as compared with the random 4-quadrant biopsy protocol [18,19]. Indeed, advanced imaging techniques such as magnifying endoscopy with narrow-band imaging, chromoendoscopy, and confocal endomicroscopy have been proposed to increase the efficiency and accuracy of endoscopic surveillance [20,21], though the classification systems used with those techniques are too complicated to be widely employed in clinical settings [22]. Moreover, the procedures require time for inspecting the entire lesion in BE segments, and diagnostic yield may depend on endoscopic expertise.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology of Barrett's Esophagus-Associated Neoplasia: Circumferential Spatial Predilection

et al. 2014

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The prevalence rates of Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) arising from BE show striking geographic patterns as they are much more common in Western as compared with Asian countries. However, recent epidemiological studies indicate that the number of patients with BE and EAC are gradually increasing in Asia including Japan, corresponding to the increase in prevalence of gastroesophageal reflux disease (GERD). Because the prognosis of patients with advanced-stage EAC remains poor, early detection of neoplastic lesion in those with BE has led to recent interest in effective treatment. Several promising studies have revealed that early neoplasia in BE is mainly located in the right anterior wall of the distal esophagus. Interestingly, this endoscopic characteristic has been found in both Western and Japanese populations. Potential pathophysiologic explanations underlying the circumferential distribution of neoplasia in BE include a nonuniform asymmetric distribution of esophageal acid exposure, with a tendency toward mucosal acid-related injury on the right side of the esophageal wall in patients with GERD, and the functional structure of the lower esophageal sphincter. Findings of the present study should improve lesion detection and aid in developing a target biopsy protocol for surveillance of BE.

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Evaluation of modified crystal violet chromoendoscopy procedure using new mucosal pit pattern classification for detection of Barrett's dysplastic lesions

Cited by 22 publications

References 22 publications

A case report of mucosal Barrett's cancer with vessel involvement, with special reference to indications for endoscopic mucosal ablation therapy

A case report of mucosal Barrett's cancer with vessel involvement, with special reference to indications for endoscopic mucosal ablation therapy

Barrett’s syndrome

Pathophysiology of Barrett's Esophagus-Associated Neoplasia: Circumferential Spatial Predilection

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